Organization
AMERITA SOUTH ATLANTIC LLC
Active
Parent organization
AMERITA, INC.
Other names
Advanced Home Infusion, Amerita
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERITA, INC.
Authorized official
RICHARD GENTLEMAN (SENIOR VICE PRESIDENT)
(720) 710-4680
Entity
Organization
Contact information
Practice address
105 JACK WHITE DR STE B, KINGSPORT, TN 37664-2364
(423) 402-8807
(833) 986-1057
Mailing address
PO BOX 223017, PITTSBURGH, PA 15251-2017
(800) 477-7375
(877) 676-0493
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
335G00000X
Medical Foods Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCPDP
4452354
TN
Enumeration date
01/13/2020
Last updated
07/28/2026
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