Amerita South Atlantic LLC
Organization Active NPI Home Infusion Therapy Pharmacy · Kingsport, TN
NPI 1801436365 · NPPES record last updated Jul 28, 2026
Key facts
- NPI
- 1801436365
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Infusion Therapy Pharmacy 3336H0001X
- Legal business name
- AMERITA SOUTH ATLANTIC LLC
- Practice address
- 105 Jack White Dr Ste B
Kingsport, TN 37664-2364 - Phone
- (423) 402-8807
- Fax
- (833) 986-1057
- NPI assigned
- Jan 13, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- AMERITA, INC.
Authorized official
- Name
- Richard Gentleman
- Title
- Senior Vice President
- Phone
- (720) 710-4680
Parent organization (reported in NPPES) 1
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 6
Member of 3
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Amerita South Atlantic LLC |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|External Infusion Pumps and/or Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200402001376 | TN | DME Supplier - Pharmacy |
0446689285 | Practice locations: Kingsport, TN |
| O20201214002139 | TN | Part B Supplier - Pharmacy | 0446689285 | Practice locations: Kingsport, TN |
National Provider Directory
- Tax ID family
- Amerita South Atlantic LLC
- Part of
- Amerita Inc
Locations
105 Jack White Dr
Ste A
Kingsport, TN 37664
Phone (423) 230-8485
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | |||
| Home Infusion Therapy Pharmacy | 3336H0001X | Yes | ||
| Medical Foods Supplier | 335G00000X |
Addresses
Primary practice location
105 Jack White Dr Ste B
Kingsport, TN 37664-2364
Mailing address
PO Box 223017
Pittsburgh, PA 15251-2017
Phone (800) 477-7375
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NCPDP | Other | TN | 4452354 |
Other names
- Advanced Home Infusion
- Amerita
Other providers in Kingsport, TN
- Janie Alton
- Anita Armaram Alwani
- Patricia B. Amadio
- American Anesthesiology Group of Tennessee, P. C.
- American Homepatient, Inc.
- Parvati Ananthula
- Srinivas Ananthula
- Kathleen Rose Anderson
- Kierra Anderson
- Lindsi Brooke Anderson
All providers in Kingsport, TN · Home Infusion Therapy Pharmacy in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.