Covered Entity Details

CAH341324-00 OUTER BANKS HEALTH HOSPITAL DBA (Active) - information as of 5/23/2025 12:14:42 AM

Main Details

Name

OUTER BANKS HEALTH HOSPITAL DBA

Subdivision Name

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH341324-00

Medicare Provider Number

341324

Additional Details

Current Program Status

Active

Registration Date

7/12/2018

Participating Start Date

10/1/2018

Participating Approval Date

7/13/2018

Last Recertification Date

8/15/2024

Contacts

Authorizing Official

ECU Health
Todd Jeffrey Warlitner, Vice President of Finance
(252) 449-4514

Primary Contact

Outer Banks Health
Kelly B Short, Pharmacy Director
(252) 449-4575

Addresses

Street Address

4800 S. CROATAN HWY
NAGS HEAD, NC 27959

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/12/2023	01/01/2024		01/01/2024
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	10/12/2023	01/01/2024		01/01/2024
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	10/12/2023	01/01/2024		01/01/2024
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	10/12/2023	01/01/2024		01/01/2024
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	10/12/2023	01/01/2024		01/01/2024
Contract Detail	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	10/12/2023	01/01/2024		01/01/2024
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/10/2020	07/01/2020		07/01/2020
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/10/2020	07/01/2020		07/01/2020
Contract Detail	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	04/10/2020	07/01/2020		07/01/2020
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	10/12/2023	01/01/2024		01/01/2024
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	10/12/2023	01/01/2024		01/01/2024
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	10/12/2023	01/01/2024		01/01/2024
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05420	770 WEST FIRE TOWER ROAD	WINTERVILLE	NC	28590	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05568	801 NORTH BROAD ST	EDENTON	NC	27932	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07335	1601 FOREST HILLS ROAD	WILSON	NC	27893	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03112	5547 N. CROATAN HIGHWAY, UNIT 26	SOUTHERN SHORES	NC	27949	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07361	1101 S. CROATAN HWY	KILL DEVIL HILLS	NC	27948	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05545	1115 US HWY 64, PO BOX 1877	MANTEO	NC	27954	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07314	507 COLLEGE STREET	CLINTON	NC	28328	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04126	1020 JOHN SMALL AVENUE	WASHINGTON	NC	27889	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03385	704 S MEMORIAL DRIVE	GREENVILLE	NC	27834	10/12/2023	01/01/2024		01/01/2024
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03620	101 W. EHRINGHAUS ST.	ELIZABETH CITY	NC	27909	10/12/2023	01/01/2024		01/01/2024
Contract Detail	PITT COUNTY MEMORIAL HOSPITAL	D/B/A ECU HEALTH SPECIALTY PHARMACY	2100 STANTONSBURG RD RM 1CC-1105	GREENVILLE	NC	27834	07/20/2020	10/01/2020	09/30/2023	10/12/2023
Contract Detail	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/15/2020	07/01/2020		07/01/2020
Contract Detail	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/10/2020	07/01/2020		07/01/2020
Contract Detail	UHS EMPLOYEE PHARMACY	D/B/A ECU HEALTH EMPLOYEE PHARMACY	2000 VENTURE TOWER DR P O BOX 6028	GREENVILLE	NC	27834	01/19/2023	04/01/2023		04/01/2023

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH341324-01	Child	CAH	OUTER BANKS HEALTH HOSPITAL DBA	OUTER BANKS HEALTH CANCER SER - Oncology	4927 SOUTH CROATAN HWY	NAGS HEAD	NC	Active
CAH341324-02	Child	CAH	OUTER BANKS HEALTH HOSPITAL DBA	OUTER BANKS HEALTH RADIATION THERAPY C - Radiation Oncology	4927 SOUTH CROATAN HWY	NAGS HEAD	NC	Active
CAH341324-03	Child	CAH	OUTER BANKS HEALTH HOSPITAL DBA	Outer Banks Health-Oncology II - Outpatient Infusion-Non Chemo	4917 South Croatan Highway	Nags Head	NC	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Warlitner, Todd Jeffrey Vice Presidnet of Finance Vidant Health 2524494514	Warlitner, Todd Jeffrey Vice President of Finance ECU Health 2524494514	8/21/2024 12:08 PM
Contacts	Signed By	Update	Profile Change Request	Warlitner, Todd Jeffrey Vice Presidnet of Finance Vidant Health 2524494514	Warlitner, Todd Jeffrey Vice President of Finance ECU Health 2524494514	8/21/2024 12:08 PM
Details	Last Recertification Date	Update	Recertification	9/7/2023 10:14:40 AM	8/15/2024 12:26:56 PM	8/15/2024 12:26 PM
Contacts	Primary Contact	Update	Group Change Request	Collins, Vance Edwin Pharmacy Director The Outer Banks Hospital 2524494575	Short, Kelly B Pharmacy Director Outer Banks Health 2524494575	6/12/2024 6:57 AM
Details	Last Recertification Date	Update	Recertification	9/12/2022 7:39:00 AM	9/7/2023 10:14:40 AM	9/7/2023 10:14 AM
Details	Entity Name	Update	Recertification	THE OUTER BANKS HOSPITAL, INC.	OUTER BANKS HEALTH HOSPITAL DBA	9/7/2023 10:14 AM
Details	Last Recertification Date	Update	Recertification	9/7/2021 8:32:31 AM	9/12/2022 7:39:00 AM	9/12/2022 7:39 AM
Details	Last Recertification Date	Update	Recertification	8/23/2020 9:06:40 AM	9/7/2021 8:32:31 AM	9/7/2021 8:32 AM
Details	Last Recertification Date	Update	Recertification	8/21/2019 11:43:45 AM	8/23/2020 9:06:40 AM	8/23/2020 9:06 AM
Details	Last Recertification Date	Update	Recertification		8/21/2019 11:43:45 AM	8/21/2019 11:43 AM
Details	State	Update		Approved	Active	10/1/2018 12:05 AM
Details	Entity Name	Update	Change Request	THE OUTER BANKS HOSPITAL	THE OUTER BANKS HOSPITAL, INC.	8/14/2018 3:15 PM
Contacts	Signed By	Insert	New Registration		Warlitner, Todd Jeffrey Vice Presidnet of Finance Vidant Health 2524494514	7/13/2018 7:34 AM
Details	340B ID	Update	New Registration		CAH341324-00	7/13/2018 7:34 AM
Dates	Participating Approval Date	Update	New Registration		7/13/2018 7:34:56 AM	7/13/2018 7:34 AM
Details	State	Update	New Registration	Pending	Approved	7/13/2018 7:34 AM
Dates	Signed By Date	Update	New Registration		7/12/2018 1:36:21 PM	7/13/2018 7:34 AM
Dates	Start Date	Update	New Registration		10/1/2018 12:00:00 AM	7/13/2018 7:34 AM
Addresses	Main Address	Insert	New Registration		4800 S. CROATAN HWY NAGS HEAD, NC 27959	7/12/2018 12:23 PM
Contacts	Authorizing Official	Insert	New Registration		Warlitner, Todd Jeffrey Vice Presidnet of Finance Vidant Health 2524494514	7/12/2018 12:23 PM
Contacts	Primary Contact	Insert	New Registration		Collins, Vance Edwin Pharmacy Director The Outer Banks Hospital 2524494575	7/12/2018 12:23 PM
Details	Last Recertification Date	Insert	New Registration			7/12/2018 12:23 PM
Details	Grant Number	Insert	New Registration			7/12/2018 12:23 PM
Details	340B ID	Insert	New Registration			7/12/2018 12:23 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/12/2018 12:23 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/12/2018 12:23 PM
Details	Medicare Provider Number	Insert	New Registration		341324	7/12/2018 12:23 PM
Details	Entity Name	Insert	New Registration		THE OUTER BANKS HOSPITAL	7/12/2018 12:23 PM
Details	Program Code	Insert	New Registration		CAH	7/12/2018 12:23 PM
Details	Entity Subname	Insert	New Registration			7/12/2018 12:23 PM
Dates	Participating Approval Date	Insert	New Registration			7/12/2018 12:23 PM
Details	State	Insert	New Registration		Pending	7/12/2018 12:23 PM
Dates	Registration Date	Insert	New Registration		7/12/2018 12:23:30 PM	7/12/2018 12:23 PM
Dates	Signed By Date	Insert	New Registration			7/12/2018 12:23 PM
Dates	Start Date	Insert	New Registration			7/12/2018 12:23 PM
Terminations	Termination Comments	Insert	New Registration			7/12/2018 12:23 PM
Terminations	Termination Date	Insert	New Registration			7/12/2018 12:23 PM
Terminations	Termination Effective Date	Insert	New Registration			7/12/2018 12:23 PM
Terminations	Termination Reason	Insert	New Registration			7/12/2018 12:23 PM