# PAS OF MEMPHIS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295904704
- **Authorized official:** IRA ANDRE RICHARDSON CRNA (OWNER)
- **Authorized official phone:** (662) 349-2588

## Contact information

- **Practice address:** 7900 AIRWAYS BLVD, BUILDING C, SUITE 2, SOUTHAVEN, MS 38671-4113
- **Practice address phone:** (662) 349-5554
- **Mailing address:** PO BOX 235022, MONTGOMERY, AL 36123-5022
- **Mailing address phone:** (334) 386-2053
- **Mailing address fax:** (334) 244-1830

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/28/2008
- **Last updated:** 02/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09852342 | — | MS |