Healthcare Provider Details

I. General information

NPI: 1508016197
Provider Name (Legal Business Name): ACCREDO HEALTH GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 CENTURY CENTER PKWY SUITE 101
MEMPHIS TN
38134-8822
US

IV. Provider business mailing address

1640 CENTURY CENTER PKWY STE 101
MEMPHIS TN
38134-8822
US

V. Phone/Fax

Practice location:
  • Phone: 901-381-7141
  • Fax: 901-261-6924
Mailing address:
  • Phone: 901-381-7141
  • Fax: 901-261-6924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. VICTOR PERINI
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 314-847-0146