Accredo Health Group Inc
Organization Active NPI Pharmacy · Salt Lake City, UT
NPI 1902857501 · NPPES record last updated May 6, 2026
Key facts
- NPI
- 1902857501
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 55435331704 (UT)
- Legal business name
- ACCREDO HEALTH GROUP INC
- Practice address
- 3488 S Main St
Salt Lake City, UT 84115-4419 - Phone
- (801) 832-0222
- Fax
- (801) 832-0333
- NPI assigned
- May 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Victor Joseph Perini
- Title
- Assistant Secretary
- Phone
- (314) 847-0146
Corporate family (same tax ID) 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in UT
- Home infusion therapy
- Medicare-enrolled home infusion therapy supplier
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081003000665 | UT | Part B Supplier - Pharmacy | 6901794007 | Practice locations: Salt Lake City, UT |
| O20100930086069 | UT | DME Supplier - Pharmacy | 6901794007 | Practice locations: Salt Lake City, UT |
| O20220214000532 | UT | Part B Supplier - Home Infusion Therapy Supplier | 6901794007 | Practice locations: South Salt Lake, UT |
National Provider Directory
- Tax ID family
- Accredo Health Group in
Locations
3488 S Main St
South Salt Lake, UT 84115
Phone (801) 832-0222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 55435331704 | UT | Yes |
| Community/Retail Pharmacy | 3336C0003X | |||
| Home Infusion Therapy Pharmacy | 3336H0001X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
3488 S Main St
Salt Lake City, UT 84115-4419
Mailing address
PO Box 954041
Saint Louis, MO 63195-0001
Phone (901) 381-7141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000203800 | Medicaid | ID | |
| 1902857501 | Medicaid | UT | |
| 000201500 | Medicaid | ID | |
| 268950 | Medicaid | OR | |
| 2100126 | Other | PK |
Other names
- ACCREDO HEALTH GROUP INC
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.