Provider Demographics
NPI:1053375253
Name:THE OUTER BANKS HOSPITAL INC
Entity type:Organization
Organization Name:THE OUTER BANKS HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:WARLITNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-449-4513
Mailing Address - Street 1:4800 S CROATAN HWY
Mailing Address - Street 2:
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-9704
Mailing Address - Country:US
Mailing Address - Phone:252-449-4500
Mailing Address - Fax:
Practice Address - Street 1:4800 S CROATAN HWY
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-9704
Practice Address - Country:US
Practice Address - Phone:252-449-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0273207Q00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC019M4OtherBCBS GROUP (HE)
NC001AHOtherBCBS
NC5907848Medicaid
NC3401324Medicaid
NC019M4OtherBCBS GROUP (HE)
NC3401324Medicaid