Provider Demographics
NPI:1871514745
Name:AMERITA, INC.
Entity type:Organization
Organization Name:AMERITA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:KATEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-631-3140
Mailing Address - Street 1:PO BOX 223017
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-2017
Mailing Address - Country:US
Mailing Address - Phone:800-477-7375
Mailing Address - Fax:877-616-0493
Practice Address - Street 1:2002 N FORBES BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-1418
Practice Address - Country:US
Practice Address - Phone:520-795-0111
Practice Address - Fax:520-795-2332
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERITA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-23
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 3336S0011X, 335G00000X
AZY005976332B00000X, 332BP3500X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No335G00000XSuppliersMedical Foods Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ327848OtherNCPDP
AZ923287Medicaid
AZY005976OtherBOARD OF PHARMACY
FA4665381OtherDEA
AZ327848OtherNCPDP