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General NPI Number Information
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NPI Number | 1407163736
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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 | 09/08/2010
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 2410 WARDLOW RD STE 101
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City | CORONA
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State | CA
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Zip | 92878-5192
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Country | US
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Telephone | 951-737-2355
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Fax | 951-737-2553
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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 | 3336M0002X
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Taxonomy Name | Mail Order 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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 50860
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License Number State | CA
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