# MEMORIAL ANESTHESIA, LLC

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

## Provider details

- **NPI number:** 1881875920
- **Authorized official:** REN J LEWIS (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (301) 829-7683

## Contact information

- **Practice address:** 8262 ATLEE RD., MOB 3 \#100, MECHANICSVILLE, VA 23116
- **Practice address phone:** (804) 746-6969
- **Practice address fax:** (804) 746-6950
- **Mailing address:** PO BOX 778, MT. AIRY, MD 21771
- **Mailing address phone:** (301) 829-7683
- **Mailing address fax:** (301) 829-7694

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | VA | — |

## Other

- **Enumeration date:** 11/16/2007
- **Last updated:** 09/17/2008