Healthcare Provider Details

I. General information

NPI: 1205730926
Provider Name (Legal Business Name): RYZEN MIDE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 OLD ANDOVER RD
NORTH READING MA
01864-1000
US

IV. Provider business mailing address

17 OLD ANDOVER RD
NORTH READING MA
01864-1000
US

V. Phone/Fax

Practice location:
  • Phone: 985-999-6575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MARC SINCLAIR
Title or Position: BILLING
Credential:
Phone: 985-999-6575