Healthcare Provider Details

I. General information

NPI: 1962284505
Provider Name (Legal Business Name): CRIMSON CARE NORTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 MITT LARY RD
NORTHPORT AL
35475-4978
US

IV. Provider business mailing address

1718 VETERANS MEMORIAL PKWY STE A
TUSCALOOSA AL
35404-4792
US

V. Phone/Fax

Practice location:
  • Phone: 205-556-5634
  • Fax: 205-556-5644
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SASANK RAHEEL PERAMSETTY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 205-556-5634