Covered Entity Details

CAH341324-01 OUTER BANKS HEALTH HOSPITAL DBA (Active) - information as of 5/23/2025 12:20:14 AM

Main Details

Name

OUTER BANKS HEALTH HOSPITAL DBA

Subdivision Name

OUTER BANKS HEALTH CANCER SER - Oncology

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH341324-01

Medicare Provider Number

341324

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/12/2018

Participating Start Date

10/1/2018

Participating Approval Date

7/17/2018

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

4927 SOUTH CROATAN HWY
NAGS HEAD, NC 27959-8508

Billing Address

The Outer Banks Hospital
4800 S. Croatan Highway
Nags Head, NC 27959

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	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

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	9/6/2023 1:37:01 PM	8/15/2024 12:25:34 PM	8/15/2024 12:25 PM
Addresses	Main Address	Update	Change Request	4810 SOUTH CROATAN HWY SUITE 210 NAGS HEAD, NC 27959-8508	4927 SOUTH CROATAN HWY NAGS HEAD, NC 27959-8508	7/1/2024 12:10 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	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	9/11/2022 11:02:45 AM	9/6/2023 1:37:01 PM	9/6/2023 1:37 PM
Details	Entity Subname	Update	Recertification	THE OUTER BANKS HOSPITAL CANCER SER - Oncology	OUTER BANKS HEALTH CANCER SER - Oncology	9/6/2023 1:37 PM
Details	Last Recertification Date	Update	Recertification	9/7/2021 8:33:46 AM	9/11/2022 11:02:45 AM	9/11/2022 11:02 AM
Details	Last Recertification Date	Update	Recertification	8/23/2020 9:06:19 AM	9/7/2021 8:33:46 AM	9/7/2021 8:33 AM
Details	Last Recertification Date	Update	Recertification	8/21/2019 11:39:42 AM	8/23/2020 9:06:19 AM	8/23/2020 9:06 AM
Details	Last Recertification Date	Update	Recertification		8/21/2019 11:39:42 AM	8/21/2019 11:39 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	7/17/2018 2:49 PM
Details	340B ID	Update	New Registration		CAH341324-01	7/17/2018 2:49 PM
Details	Entity Subname	Update	New Registration	THE OUTER BANKS HOSPITAL CANCER SER	THE OUTER BANKS HOSPITAL CANCER SER - Oncology	7/17/2018 2:49 PM
Dates	Participating Approval Date	Update	New Registration		7/17/2018 2:49:05 PM	7/17/2018 2:49 PM
Details	State	Update	New Registration	Pending	Approved	7/17/2018 2:49 PM
Dates	Signed By Date	Update	New Registration		7/12/2018 1:37:44 PM	7/17/2018 2:49 PM
Dates	Start Date	Update	New Registration		10/1/2018 12:00:00 AM	7/17/2018 2:49 PM
Addresses	Main Address	Insert	New Registration		4810 SOUTH CROATAN HWY SUITE 210 NAGS HEAD, NC 27959-8508	7/12/2018 12:39 PM
Addresses	Billing Address	Insert	New Registration		The Outer Banks Hospital 4800 S. Croatan Highway Nags Head, NC 27959	7/12/2018 12:39 PM
Contacts	Authorizing Official	Insert	New Registration		Warlitner, Todd Jeffrey Vice Presidnet of Finance Vidant Health 2524494514	7/12/2018 12:39 PM
Contacts	Primary Contact	Insert	New Registration		Collins, Vance Edwin Pharmacy Director The Outer Banks Hospital 2524494575	7/12/2018 12:39 PM
Details	Last Recertification Date	Insert	New Registration			7/12/2018 12:39 PM
Details	Grant Number	Insert	New Registration			7/12/2018 12:39 PM
Details	340B ID	Insert	New Registration			7/12/2018 12:39 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/12/2018 12:39 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/12/2018 12:39 PM
Details	Medicare Provider Number	Insert	New Registration		341324	7/12/2018 12:39 PM
Details	Entity Name	Insert	New Registration		THE OUTER BANKS HOSPITAL	7/12/2018 12:39 PM
Details	Program Code	Insert	New Registration		CAH	7/12/2018 12:39 PM
Details	Entity Subname	Insert	New Registration		THE OUTER BANKS HOSPITAL CANCER SER	7/12/2018 12:39 PM
Dates	Participating Approval Date	Insert	New Registration			7/12/2018 12:39 PM
Details	State	Insert	New Registration		Pending	7/12/2018 12:39 PM
Dates	Registration Date	Insert	New Registration		7/12/2018 12:39:07 PM	7/12/2018 12:39 PM
Dates	Signed By Date	Insert	New Registration			7/12/2018 12:39 PM
Dates	Start Date	Insert	New Registration			7/12/2018 12:39 PM
Terminations	Termination Comments	Insert	New Registration			7/12/2018 12:39 PM
Terminations	Termination Date	Insert	New Registration			7/12/2018 12:39 PM
Terminations	Termination Effective Date	Insert	New Registration			7/12/2018 12:39 PM
Terminations	Termination Reason	Insert	New Registration			7/12/2018 12:39 PM