Provider Demographics
NPI:1568571610
Name:ANESTHESIA SERVICES OF MEMPHIS, PLLC
Entity Type:Organization
Organization Name:ANESTHESIA SERVICES OF MEMPHIS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABE
Authorized Official - Middle Name:I
Authorized Official - Last Name:ABUELOUF
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:901-737-8571
Mailing Address - Street 1:124 TIMBER CREEK DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4280
Mailing Address - Country:US
Mailing Address - Phone:901-737-8571
Mailing Address - Fax:901-737-6350
Practice Address - Street 1:124 TIMBER CREEK DR
Practice Address - Street 2:SUITE 2
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4280
Practice Address - Country:US
Practice Address - Phone:901-737-8571
Practice Address - Fax:901-737-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC04534Medicare PIN
TN3723246Medicare ID - Type Unspecified