NPIMap

Organization Active NPI

Our Lady of Lourdes Memorial Hospital Inc

  • Community/Retail Pharmacy
  • Binghamton, NY
National Provider Identifier
1265077069
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
Practice address
17 Chenango Bridge Rd
Binghamton, NY 13901-1233
Phone
(607) 798-5500
Fax
(607) 798-5501
NPI assigned
Nov 15, 2019
Organization subpart
Yes
Parent organization
OUR LADY OF LOURDES MEMORIAL HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shayne Wilcox
Title
Director, Community Pharmacy
Phone
(607) 798-5911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

17 Chenango Bridge Rd
Binghamton, NY 13901-1233

Mailing address

169 Riverside Dr
Binghamton, NY 13905-4198
Phone (607) 798-5004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210203002953 NY DME Supplier - Pharmacy 1254237779 Practice locations: Binghamton, NY
O20220713001636 NY Part B Supplier - Pharmacy 1254237779 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Binghamton, NY; Johnson City, NY; Vestal, NY

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Our Lady of Lourdes Memorial Hospi17 Chenango Bridge Rd, Binghamton, NY 13901-1233(607) 798-5500 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
George F Henningiii12 organizations share this tax ID, including this one
Part of
George F Henningiii

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1265077069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054198",
            "telephone_number": "607-798-5004",
            "fax_number": "607-798-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CHENANGO BRIDGE RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139011233",
            "telephone_number": "607-798-5500",
            "fax_number": "607-798-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES MEMORIAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUR LADY OF LOURDES MEMORIAL HOSPITAL INC",
        "enumeration_date": "2019-11-15",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "SHAYNE",
        "authorized_official_title_or_position": "DIRECTOR, COMMUNITY PHARMACY",
        "authorized_official_telephone_number": "607-798-5911"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.