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NPI 1730612953

NPI 1730612953 : ACCREDO HEALTH GROUP, INC. : TEMPE, AZ

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General NPI Number Information
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    NPI Number           |    1730612953
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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     |    04/05/2017
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    Last Update Date     |    12/05/2025
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Provider Practice Location Address
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    Address Line         |    2040 W RIO SALADO PKWY STE 101B
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    City                 |    TEMPE
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    State                |    AZ
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    Zip                  |    85281-2802
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    Country              |    US
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    Telephone            |    602-944-1199
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    Fax                  |    602-944-1787
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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                 |    MR. VICTOR B 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       |    Y002074
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    License Number State |    AZ
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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       |    Y002074
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    License Number State |    AZ
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