Organization · Type 2 NPI

Our Lady of Lourdes Memorial Hospital, Inc.

Community/Retail Pharmacy · Vestal, NY

NPI number 1063824852 Active

Practice location

3101 Shippers Rd Ste 104
Vestal, NY 13850-2003

Call (607) 251-2151 Map

Fax (607) 251-2194

Mailing address

3101 Shippers Rd, Suite 104
Vestal, NY 13850-2003

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	032604 (NY)
Compounding Pharmacy	3336C0004X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

Other community/retail pharmacy providers in Vestal

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NPI record

NPI: 1063824852
Entity type: Organization (Type 2)
Issued: May 28, 2014
Last updated: Jun 18, 2026
Status: Active
Subpart: Yes of Our Lady of Lourdes Memorial Hospital Inc

Other names

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Lourdes Pharmacy · doing business as

Authorized official

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

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1063824852

Our Lady of Lourdes Memorial Hospital, Inc.'s National Provider Identifier is 1063824852, issued on May 28, 2014. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Vestal, NY. The record was last updated on Jun 18, 2026.