Organization
OUTER BANKS DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD J WARLITNER (CFO)
(252) 449-4514
Entity
Organization
Contact information
Practice address
115 EXETER ST, MANTEO, NC 27954-9400
(252) 475-3530
(252) 475-3534
Mailing address
115 EXETER ST, MANTEO, NC 27954-9400
(252) 475-3530
(252) 475-3534
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3402598
—
NC
Enumeration date
07/31/2018
Last updated
07/31/2018
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