Provider Demographics
NPI:1922756477
Name:AMERITA, INC.
Entity Type:Organization
Organization Name:AMERITA, INC.
Other - Org Name:IVY SPECIALTY INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP MANAGED CARE CONTRACTING
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:720-282-5325
Mailing Address - Fax:877-676-0493
Practice Address - Street 1:1200 AIRPORT HEIGHTS DR STE 195
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2982
Practice Address - Country:US
Practice Address - Phone:806-352-1212
Practice Address - Fax:806-352-1211
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERITA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-14
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No335G00000XSuppliersMedical Foods Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0228824OtherNCPDP