Provider Demographics
NPI:1770595449
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:877-676-0493
Practice Address - Street 1:12515 E 55TH ST STE 101
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-6234
Practice Address - Country:US
Practice Address - Phone:918-493-2727
Practice Address - Fax:918-493-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7493251E00000X, 251F00000X
OK2-7746332B00000X, 332BP3500X, 3336S0011X, 3336H0001X
335G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No335G00000XSuppliersMedical Foods Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100242220BMedicaid
OK100242220AMedicaid
3719638OtherNCPDP
3719638OtherNCPDP
FS3617466OtherDEA
COOSP.0005998OtherPHARMACY LICENSE
NVPH02937OtherPHARMACY LICENSE
FLPH26013OtherPHARMACY LICENSE
NY032286OtherPHARMACY LICENSE
OK100242220BMedicaid
MO2013000703OtherPHARMACY LICENSE
OK100242220CMedicaid
OK45478OtherNARCOTICS AND DANGEROUS DRUGS
WYNR-50600OtherPHARMACY LICENSE
FLPH26013OtherPHARMACY LICENSE
OK100242220BMedicaid
AK1163OtherPHARMACY LICENSE
OK7493OtherHOME CARE AGENCY LICENSE
CTPCN.0002275OtherPHARMACY LICENSE
TX27177OtherPHARMACY LICENSE
MSF09160OtherPHARMACY LICENSE
OK2-6734OtherBOARD OF PHARMACY