MEDICARE: ACCREDO HEALTH GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336M0002X	Mail Order Pharmacy
2	333600000X	Pharmacy

General Provider Information

NPI Number	:	1548855406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCREDO HEALTH GROUP, INC.

Provider Business Mailing Address
First Line	:	PO BOX 954041
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-0001
Country	:	US
Telephone Number	:	901-381-7141
Fax Number	:

Provider Business Practice Location Address
First Line	:	1335 E SUNSET RD STE J
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4935
Country	:	US
Telephone Number	:	702-895-8990
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	VICTOR JOSEPH PERINI
Credential	:
Telephone Number	:	314-684-6750

Provider Enumeration Date	:	03/03/2021
Last Update Date	:	12/05/2025

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