Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ridge Lake ASC, LLC

Organization Ambulatory Surgical Clinic/Center · NPI 1790844132

Ridge Lake ASC, LLC is an Ambulatory Surgical Clinic/Center in Memphis, Tennessee. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone: (901) 685-2200
Fax: (901) 820-2342
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmologic Surgery Clinic/Center (primary) Taxonomy 261QS0132X · Licence 0000000049 (TN)
Ambulatory Surgical Clinic/Center Taxonomy 261QA1903X · Licence 0000000049 (TN)

Record details

NPI number1790844132
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Subba Gollamudi — Managing Partner · (901) 685-2200
NPI enumeratedDecember 8, 2006
Last updated in NPPESJuly 25, 2022
Certification dateJuly 25, 2022
Mailing address825 Ridge Lake Blvd, Memphis, TN 38120-9411

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