Organization
OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Active
Parent organization
OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
Other names
Lourdes Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
Authorized official
SHAYNE WILCOX (DIRECTOR, COMMUNITY PHARMACY)
(607) 798-5911
Entity
Organization
Contact information
Practice address
3101 SHIPPERS RD STE 104, VESTAL, NY 13850-2003
(607) 251-2151
(607) 251-2194
Mailing address
3101 SHIPPERS RD, SUITE 104, VESTAL, NY 13850-2003
(607) 251-2151
(607) 251-2194
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
032604
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145824
PK
—
Enumeration date
05/28/2014
Last updated
06/18/2026
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