Provider Demographics
NPI:1598864134
Name:AMERITA, INC.
Entity Type:Organization
Organization Name:AMERITA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILOLAHTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-282-2382
Mailing Address - Street 1:6912 S QUENTIN ST STE 50
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4531
Mailing Address - Country:US
Mailing Address - Phone:720-282-5411
Mailing Address - Fax:877-302-5251
Practice Address - Street 1:3775 CROSSINGS DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7138
Practice Address - Country:US
Practice Address - Phone:928-708-0025
Practice Address - Fax:928-708-0288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERITA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-21
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 3336S0011X, 335G00000X
AZY005977332B00000X, 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
AZ922610Medicaid
0320692OtherNCPDP
AZY007460OtherPHARMACY
AZY007460OtherPHARMACY
AZ320692OtherNCPDP