1134136195 NPI number — AMERITA, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134136195 NPI number — AMERITA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERITA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134136195
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 223017
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15251-2017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-477-7375
Provider Business Mailing Address Fax Number:
877-676-0493

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7307 S REVERE PKWY
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
CENTENNIAL
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80112-3931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-355-4745
Provider Business Practice Location Address Fax Number:
303-322-7022
Provider Enumeration Date:
08/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KATEN
Authorized Official First Name:
ALEXANDER
Authorized Official Middle Name:
LAWRENCE
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
772-631-3140

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: PDO-401 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 335G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0614758 . This is a "NCPDP" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: PDO-401 . This is a "BOARD OF PHARMACY" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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