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General NPI Number Information
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NPI Number | 1275589830
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Entity Type | Organization
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Legal Business Name | ACCREDO HEALTH GROUP INC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 22623 68TH AVE S
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City | KENT
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State | WA
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Zip | 98032-1981
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Country | US
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Telephone | 253-872-2121
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Fax | 253-872-5663
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Provider Business Mailing Address
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Address Line | PO BOX 954041
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City | SAINT LOUIS
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State | MO
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Zip | 63195-0001
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Country | US
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Telephone | 901-381-7141
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Fax | 901-261-6924
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | VIC PERINI
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Credential |
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Telephone | 314-684-6273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHAR.CF.00004193
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License Number State | WA
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