Active NPI
Accredo Health Group Inc
- Pharmacy
- Irving, TX
National Provider Identifier
1073569034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 22254
- Legal business name
- ACCREDO HEALTH GROUP INC
- Doing business as
- Accredo Health Group Inc
- Practice address
- 4343 W Royal LN
Ste 124
Irving, TX 75063-2324 - Phone
- (972) 929-6800
- Fax
- (972) 929-6945
- NPI assigned
- May 25, 2006
- Last updated
- Dec 5, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vic Perini
- Title
- Assistant Secretary
- Phone
- (314) 684-6273
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | 22254 | TX | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU | ||
| Home Infusion Therapy Pharmacy | 3336H0001X | NU | ||
| Specialty Pharmacy | 3336S0011X | NU |
Addresses
Primary practice location
4343 W Royal LN
Ste 124
Irving, TX 75063-2324
Mailing address
PO Box 954041
Saint Louis, MO 63195-7568
Phone (901) 381-7141
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 151917501 | Medicaid | TX | |
| 159765001 | Medicaid | TX | |
| 320242 | Medicaid | TX | |
| 151917504 | Medicaid | TX | |
| 2097264 | Other | PK | |
| 151917505 | Medicaid | TX | |
| 151917506 | Medicaid | TX | |
| 159765002 | Medicaid | TX |
Other names 1
- ACCREDO HEALTH GROUP INC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, NJ, TX
Enrollment records 5
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040611000410 | AZ | Part B Supplier - Pharmacy | 6901794007 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tempe, AZ |
| O20040615001753 | NJ | Part B Supplier - Pharmacy | 6901794007 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Pine Brook, NJ |
| O20070212000457 | TX | Part B Supplier - Pharmacy | 6901794007 | Practice locations: Irving, TX |
| O20100930044435 | TX | DME Supplier - Pharmacy | 6901794007 | Practice locations: Irving, TX |
| O20210610000830 | TX | Part B Supplier - Home Infusion Therapy Supplier | 6901794007 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Houston, TX; Irving, TX |
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Specialty Pharmacy
- Orlando, FL
- NPI 1043309735
O20040611000410, O20040615001753
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1764892800000",
"number": "1073569034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 954041",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631957568",
"telephone_number": "901-381-7141",
"fax_number": "901-261-6924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4343 W ROYAL LN",
"address_2": "STE 124",
"city": "IRVING",
"state": "TX",
"postal_code": "750632324",
"telephone_number": "972-929-6800",
"fax_number": "972-929-6945"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACCREDO HEALTH GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"last_updated": "2025-12-05",
"certification_date": "2025-12-05",
"status": "A",
"authorized_official_last_name": "PERINI",
"authorized_official_first_name": "VIC",
"authorized_official_title_or_position": "ASSISTANT SECRETARY",
"authorized_official_telephone_number": "314-684-6273"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "22254",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "151917501",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "159765001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "320242",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "151917504",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2097264",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "151917505",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "151917506",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "159765002",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ACCREDO HEALTH GROUP INC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "ACCREDO HEALTH GROUP INC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Irving, TX
- Academic Medical Associates PLLC
- Accelerant Healthcare Solutions
- Access Pain & Injury Clinic LLC
- Accident & Injury Pain Centers Inc. (Accident & Injury Chiropractic)
- Acclaim Home Health, Inc.
- Accredo Health Group Inc
- Accucare, Inc.
- Nelson Fon Achu, NP
- Acigna Home Health Services Inc
- Christine M Acker, ARNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.