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Organization
OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Active
Organization
OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYNE WILCOX (DIRECTOR, COMMUNITY PHARMACY)
(607) 798-5911
Entity
Organization
Contact information
Practice address
477 STATE ST, BINGHAMTON, NY 13901-2378
(607) 584-9376
(607) 584-9380
Mailing address
477 STATE ST, BINGHAMTON, NY 13901-2378
(607) 584-9376
(607) 584-9380
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
029413
NY
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159729
PK
—
Enumeration date
04/25/2016
Last updated
09/28/2026
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