OUR LADY OF LOURDES MEMORIAL HOSPITAL INC NPI 1336197714

NPI Information

NPI: 1336197714
Provider Name: OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC

Doing Business As: HOSPICE AT LOURDES

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
4102 OLD VESTAL RD
VESTAL, NY
ZIP 13850
Phone: (607) 798-5692
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OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC is a hospice care community based in Vestal, NY. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC NPI is 1336197714. The provider is registered as an organization entity type.
The provider Is Doing Business As Hospice At Lourdes.

The provider's business location address is:

4102 OLD VESTAL RD
VESTAL, NY
ZIP 13850-531
Phone: (607) 798-5692
Fax: (607) 352-1738

The provider's authorized official is Brian Regan .
The authorized official title is Sr Vp & Cfo and has the following contact phone number (607) 798-5271.

The enumeration date for this NPI number is 5/5/2006 and was last updated on 8/22/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		0301501F	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3300115	OTHER	NEW YORK	EMPIRE BC/BS PROVIDER NUM
2	331505	OTHER	NEW YORK	BC/BS OF CENTRAL NY
3	2105209	OTHER		AETNA PROVIDER NUMBER
4	528113	OTHER	NEW YORK	MVP PROVIDER NUMBER
5	331505	MEDICARE ID-TYPE UNSPECIFIED		MEDICARE PROVIDER NUMBER
6	955775	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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