Provider Demographics
NPI:1386182608
Name:OUTER BANKS PROFESSIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:OUTER BANKS PROFESSIONAL SERVICES, LLC
Other - Org Name:OUTER BANKS HOSPITAL URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:WARLITNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-449-4514
Mailing Address - Street 1:PO BOX 8427
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-8427
Mailing Address - Country:US
Mailing Address - Phone:
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
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:2017-02-07
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care