Healthcare Provider Details

I. General information

NPI: 1801874102
Provider Name (Legal Business Name): THE OUTER BANKS HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 12/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 S CROATAN HWY
NAGS HEAD NC
27959-9704
US

IV. Provider business mailing address

4800 S CROATAN HWY
NAGS HEAD NC
27959-9704
US

V. Phone/Fax

Practice location:
  • Phone: 252-449-4500
  • Fax:
Mailing address:
  • Phone: 252-449-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberH0273
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberH0273
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberH0273
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH0273
License Number StateNC

VIII. Authorized Official

Name: MR. TODD WARLITNER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 252-449-4513