Organization
OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS JOHN FORREST (OUTPATIENT PHARMACY DIRECTOR)
(607) 798-5944
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
Primary
029413
NY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159729
PK
—
Enumeration date
04/25/2016
Last updated
04/03/2020
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