Provider Demographics
NPI:1801874102
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:CHIEF FINANCIAL OFFICER
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?:Yes
Parent Organization LBN:THE OUTER BANKS HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-06
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0273207L00000X, 207P00000X, 367500000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017MFOtherHOSPITALISTS GROUP #
NC8000307Medicaid
NC5904773Medicaid
NC020P7OtherBCBS ANESTHESIOLOGY GROUP #
NC5904773Medicaid
NC2352727AMedicare ID - Type UnspecifiedANESTHESIOLOGY GROUP #
NC2352727BMedicare ID - Type UnspecifiedHOSPITALISTS GROUP #