AMERITA SOUTH ATLANTIC LLC (NPI# 1801436365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801436365 |
| Entity Type | Organization |
| Organization Name | AMERITA SOUTH ATLANTIC LLC |
| Other Organization Name | ADVANCED HOME INFUSION |
| Practice Address |
105 Jack White Dr Ste B Kingsport TN 37664-2364 |
| Mailing Address |
6912 S Quentin St Ste 50 Centennial CO 80112-4531 |
| Practice Telephone | 4233787350 |
| Practice Fax Number | 8339861057 |
| Mailing Telephone | 7202825411 |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-02-28 |
| Authorized Official Name | RICHARD D IRIYE (PRESIDENT) |
| Authorized Official Telephone | 3034070655 |
| Is Organization Subpart | Y |
| Parent Organization Name | AMERITA, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Advanced Home Infusion | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841830197 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 1231 Ne Maynard Rd Ste A, Cary, NC 27513-4175 | 2020-01-14 |
| 1780224030 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 5901 Goshen Springs Rd Ste H, Norcross, GA 30071-3506 | 2020-01-14 |
| 1588204846 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 2520 Whitehall Park Dr Ste 1000, Charlotte, NC 28273 | 2020-01-14 |
| 1962041368 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 4001 Piedmont Pkwy Ste 150, High Point, NC 27265-9402 | 2020-01-02 |
| 1215559703 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 2424 India Hook Rd Ste 130, Rock Hill, SC 29732-1278 | 2020-05-07 |
| 1750921011 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 30 Ebco Cir Ste 102, Waynesboro, VA 22980-7374 | 2020-01-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Amerita South Atlantic LLC | 805 N Whittington Pkwy Ste 400, Louisville, Kentucky 40222-5186 |
| North Carolina Corporations | Amerita South Atlantic LLC | 2626 Glenwood Ave Ste 550, Raleigh, NC 27608 |
| Street Address |
105 JACK WHITE DR STE B |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37664-2364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972067395 | Alice Victoria Lilly | Nurse Practitioner | 2995 Ft. Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-30 |
| 1861966525 | Catherine Ann Hensley | Nurse Practitioner | 2995 Fort Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-16 |
| 1679076954 | Christopher A Hillman | Dentist | 1599 Fort Henry Dr Ste 102, Kingsport, TN 37664 | 2018-03-13 |
| 1154666733 | Cristin Patterson | Counselor | 2762 East Center St., Kingsport, TN 37664 | 2012-12-07 |
| 1972851095 | Kevin Michael Smith | Pharmacist | 1425 East Center Street, Kingsport, TN 37664 | 2012-08-21 |
| 1619299617 | Kelli Lynn Dillon | Counselor | 1570 Waverly Rorad, Kingsport, TN 37664 | 2010-02-18 |
| 1356503726 | Charles Craig Stieler | Hearing Instrument Specialist | 2101 Ft Henry Dr, Kingsport, TN 37664 | 2008-06-27 |
| 1104012319 | Pro Balance LLC | Prosthetic/Orthotic Supplier | 2408 Fort Henry Drive, Kingsport, TN 37664 | 2007-09-20 |
| 1518188648 | Remington House | Assisted Living Facility | 640 Rock Springs Road, Kingsport, TN 37664 | 2007-05-02 |
| 1689795007 | Elaine Frazier | Emergency Medicine | 410 Golf Ridge Dr, Kingsport, TN 37664 | 2007-04-03 |
| Find all providers in zip 37664 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679040281 | Nutritional Pharmacy Services, LLC | Pharmacy | 1838 Elm Hill Pike Ste 120, Nashville, TN 37210-3726 | 2018-11-01 |
| 1922584531 | Pharmacy Services of America, LLC | Pharmacy | 1838 Elm Hill Pike Ste 118, Nashville, TN 37210-3726 | 2018-07-17 |
| 1518349562 | Acro Pharmaceutical Services LLC | Pharmacy | 7891 Stage Hills Blvd Ste 111, Bartlett, TN 38133-4052 | 2015-06-26 |
| 1467724153 | Paragon Hemophilia Solutions | Pharmacy | 107 Imperial Blvd Ste 9, Hendersonville, TN 37075-3492 | 2012-01-27 |
| 1629364864 | Bradley's Home Health Care Center | Pharmacy | 5208 Charlotte Avenue, Nashville, TN 37209-3321 | 2011-06-27 |
| 1477728491 | Wilson Pharmacy, Inc | Pharmacy | 523 N State of Franklin Rd Ste B, Johnson City, TN 37604-8210 | 2008-04-30 |
| 1528154259 | Continucare Healthservices, Inc. - Hme East | Pharmacy | 1651 Gunbarrel Road, Suite 101-b, Chattanooga, TN 37421 | 2006-10-04 |
| 1962468181 | Medical Alternatives | Pharmacy | 6949 Appling Farms Pkwy, Suite 109, Memphis, TN 38133-4731 | 2006-04-25 |
| 1720357908 | Ffp Acquisition II, LLC | Pharmacy | 8024 Stage Hills Blvd, Suite 107, Memphis, TN 38133-4048 | 2011-12-18 |
| 1407152689 | St. Jude Hospital Pharmacy | Pharmacy | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2011-02-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on AMERITA SOUTH ATLANTIC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.