NPI Code Details Logo

NPI 1770595449

NPI 1770595449 : AMERITA, INC. : TULSA, OK

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1770595449
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    AMERITA, INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/12/2006
-----------------------------------------------------
    Last Update Date     |    10/02/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    12515 E 55TH ST STE 101 
-----------------------------------------------------
    City                 |    TULSA
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    74146-6234
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    918-493-2727
-----------------------------------------------------
    Fax                  |    918-493-2990
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 223017 
-----------------------------------------------------
    City                 |    PITTSBURGH
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    15251-2017
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    800-477-7375
-----------------------------------------------------
    Fax                  |    877-676-0493
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CFO
-----------------------------------------------------
    Name                 |     ALEXANDER LAWRENCE KATEN 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    772-631-3140
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    7493
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    251F00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Infusion Agency
-----------------------------------------------------
    License Number       |    7493
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    332B00000X
-----------------------------------------------------
    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
    License Number       |    2-7746
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    332BP3500X
-----------------------------------------------------
    Taxonomy Name        |    Parenteral & Enteral Nutrition Supplies (DME)
-----------------------------------------------------
    License Number       |    2-7746
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    3336S0011X
-----------------------------------------------------
    Taxonomy Name        |    Specialty Pharmacy
-----------------------------------------------------
    License Number       |    2-7746
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    335G00000X
-----------------------------------------------------
    Taxonomy Name        |    Medical Foods Supplier
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    3336H0001X
-----------------------------------------------------
    Taxonomy Name        |    Home Infusion Therapy Pharmacy
-----------------------------------------------------
    License Number       |    2-7746
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.