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Organization

OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.

Active
Parent organization
OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
Other names
Lourdes Retail 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
169 RIVERSIDE DR, BINGHAMTON, NY 13905-4246
(607) 798-5944
(607) 798-5972
Mailing address
169 RIVERSIDE DR, RETAIL PHARMACY, BINGHAMTON, NY 13905-4246
(607) 798-5944
(607) 798-5972

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
023594
NY
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01909851
NY
01
2063510
PK
Enumeration date
06/12/2006
Last updated
06/18/2026
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