NPIMap

Our Lady of Lourdes Memorial Hospital, Inc.

Organization Active NPI Pharmacy · Binghamton, NY

NPI 1710332002 · NPPES record last updated Jun 17, 2026

Key facts

NPI
1710332002
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
License
029413 (NY)
Legal business name
OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Practice address
477 State St
Binghamton, NY 13901-2378
Phone
(607) 584-9376
Fax
(607) 584-9380
NPI assigned
Apr 25, 2016
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 5

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

Other NPIs with the same Medicare PAC ID 9

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

Corporate family (same tax ID) 11

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

Practitioners 249

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 249

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Our Lady of Lourdes Memorial Hospit
477 State St, Binghamton, NY 13901-2360 · (607) 584-9376		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignment
Participating since Oct 1, 1984

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20181018002532 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

National Provider Directory

Tax ID family
George F Henningiii (12 organizations share this tax ID)

Locations

477 State St
Binghamton, NY 13901
Phone (607) 584-9376

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 029413 NY Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

477 State St
Binghamton, NY 13901-2378

Mailing address

477 State St
Binghamton, NY 13901-2378
Phone (607) 584-9376

Other identifiers

IdentifierTypeStateIssuer
2159729OtherPK

Other providers in Binghamton, NY

All providers in Binghamton, NY · Pharmacy in New York

Sources for this page

Verify at the official NPI Registry.