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  5. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.

OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.

Company Details

Name: OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 20 May 1936 (89 years ago)
Entity Number: 38264
ZIP code: 12207
County: Broome
Place of Formation: New York
Address: 80 STATE STREET, ALBANY, NY, United States, 12207

Contact Details

Phone +1 607-798-5111

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
MR9LDZZZBZW6 2025-04-25 169 RIVERSIDE DR, BINGHAMTON, NY, 13905, 4246, USA 169 RIVERSIDE DR, BINGHAMTON, NY, 13905, 4198, USA

Business Information
Division Name YOUTH SERVICES
Congressional District 19
State/Country of Incorporation NY, USA
Activation Date 2024-04-29
Initial Registration Date 2006-01-18
Entity Start Date 1936-05-20
Fiscal Year End Close Date Jun 30

Points of Contacts
Electronic Business
Title PRIMARY POC
Name GABRIELLA SNYDER
Role GRANTS MANAGER
Address 1345 PHILOMENA ST, STE 362, AUSTIN, TX, 78723, USA
Title ALTERNATE POC
Name AMY PRATT
Address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905, USA
Government Business
Title PRIMARY POC
Name ROB MADSEN
Role DIRECTOR-ACCOUNTING & REPORTING
Address 1345 PHILOMENA ST, AUSTIN, TX, 78723, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
49KV4 Obsolete Non-Manufacturer 2006-01-18 2024-04-29 No data 2025-04-25

Contact Information
POC ROB MADSEN
Phone +1 512-324-5615
Address 169 RIVERSIDE DR, BINGHAMTON, NY, 13905 4246, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OUR LADY OF LOURDES MEMORIAL HOSPITAL EMPLOYEE HEALTH AND GROUP INSURANCE PLAN 2012 150532221 2013-10-03 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. 1672
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1994-01-01
Business code 622000
Sponsor’s telephone number 6075849459
Plan sponsor’s mailing address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Plan sponsor’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905

Number of participants as of the end of the plan year
Active participants 1639
Retired or separated participants receiving benefits 10

Signature of
Role Plan administrator
Date 2013-10-03
Name of individual signing MARY HUGHS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-03
Name of individual signing DAVID PATAK
Valid signature Filed with authorized/valid electronic signature
OUR LADY OF LOURDES DENTAL AND VISION 2011 150532221 2012-10-15 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. 2289
File View Page
Three-digit plan number (PN) 516
Effective date of plan 1997-01-01
Business code 622000
Sponsor’s telephone number 6075849459
Plan sponsor’s mailing address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Plan sponsor’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905

Plan administrator’s name and address
Administrator’s EIN 150532221
Plan administrator’s name OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Plan administrator’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Administrator’s telephone number 6075849459

Number of participants as of the end of the plan year
Active participants 2349
Retired or separated participants receiving benefits 2

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing MARY HUGHS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-15
Name of individual signing DAVID PATAK
Valid signature Filed with authorized/valid electronic signature
OUR LADY OF LOURDES MEMORIAL HOSPITAL EMPLOYEE HEALTH AND GROUP INSURANCE PLAN 2011 150532221 2012-10-15 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. 1753
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1994-01-01
Business code 622000
Sponsor’s telephone number 6075849459
Plan sponsor’s mailing address 169 RIVERSID DRIVE, BINGHAMTON, NY, 13905
Plan sponsor’s address 169 RIVERSID DRIVE, BINGHAMTON, NY, 13905

Plan administrator’s name and address
Administrator’s EIN 150532221
Plan administrator’s name OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Plan administrator’s address 169 RIVERSID DRIVE, BINGHAMTON, NY, 13905
Administrator’s telephone number 6075849459

Number of participants as of the end of the plan year
Active participants 1721
Retired or separated participants receiving benefits 6

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing MARY HUGHS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-15
Name of individual signing DAVID PATAK
Valid signature Filed with authorized/valid electronic signature
OUR LADY OF LOURDES MEMORIAL HOSPITAL EMPLOYEE HEALTH AND GROUP INSURANCE PLAN 2010 150532221 2011-07-29 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. 1535
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1994-01-01
Business code 622000
Sponsor’s telephone number 6075849459
Plan sponsor’s mailing address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Plan sponsor’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905

Plan administrator’s name and address
Administrator’s EIN 150532221
Plan administrator’s name OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Plan administrator’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Administrator’s telephone number 6075849459

Number of participants as of the end of the plan year
Active participants 1561
Retired or separated participants receiving benefits 25

Signature of
Role Plan administrator
Date 2011-07-27
Name of individual signing MARY HUGHS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-29
Name of individual signing DAVID PATAK
Valid signature Filed with authorized/valid electronic signature
OUR LADY OF LOURDES DENTAL AND VISION 2010 150532221 2011-07-29 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC 2126
File View Page
Three-digit plan number (PN) 516
Effective date of plan 1997-01-01
Business code 622000
Sponsor’s telephone number 6075849459
Plan sponsor’s mailing address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Plan sponsor’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905

Plan administrator’s name and address
Administrator’s EIN 150532221
Plan administrator’s name OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC
Plan administrator’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Administrator’s telephone number 6075849459

Number of participants as of the end of the plan year
Active participants 2199
Retired or separated participants receiving benefits 3

Signature of
Role Plan administrator
Date 2011-07-29
Name of individual signing MARY HUGHS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-29
Name of individual signing DAVID PATAK
Valid signature Filed with authorized/valid electronic signature
OUR LADY OF LOURDES MEMORIAL HOSPITAL EMPLOYEE HEALTH AND GROUP INSURANCE PLAN 2009 150532221 2010-07-26 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC 1537
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1994-01-01
Business code 622000
Sponsor’s telephone number 6075849459
Plan sponsor’s mailing address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Plan sponsor’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905

Plan administrator’s name and address
Administrator’s EIN 150532221
Plan administrator’s name OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC
Plan administrator’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Administrator’s telephone number 6075849459

Number of participants as of the end of the plan year
Active participants 1509
Retired or separated participants receiving benefits 26
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-07-26
Name of individual signing MARY HUGHS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-26
Name of individual signing DAVID PATAK
Valid signature Filed with authorized/valid electronic signature
OUR LADY OF LOURDES DENTAL AND VISION 2009 150532221 2010-07-26 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC 2058
File View Page
Three-digit plan number (PN) 516
Effective date of plan 1997-01-01
Business code 622000
Sponsor’s telephone number 6075849459
Plan sponsor’s mailing address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Plan sponsor’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905

Plan administrator’s name and address
Administrator’s EIN 150532221
Plan administrator’s name OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC
Plan administrator’s address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Administrator’s telephone number 6075849459

Number of participants as of the end of the plan year
Active participants 2122
Retired or separated participants receiving benefits 4
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-07-26
Name of individual signing MARY HUGHS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-26
Name of individual signing DAVID PATAK
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
C/O CORPORATION SERVICE COMPANY DOS Process Agent 80 STATE STREET, ALBANY, NY, United States, 12207

Agent

Name Role Address
N/A: THE CORP Agent 169 RIVERSIDE DR., BINGHAMTON, NY, 13905

History

Start date End date Type Value
2017-10-31 2024-02-02 Address 80 STATE STREET, ALBANY, NY, 12207, 2543, USA (Type of address: Service of Process)
2000-02-24 2017-10-31 Address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905, USA (Type of address: Service of Process)
1997-09-22 2000-02-24 Address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13901, USA (Type of address: Service of Process)
1995-05-12 1997-09-22 Address 169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13901, USA (Type of address: Service of Process)
1973-09-20 2024-02-02 Address 169 RIVERSIDE DR., BINGHAMTON, NY, 13905, USA (Type of address: Registered Agent)

Filings

Filing Number Date Filed Type Effective Date
240202001412 2024-02-01 RESTATED CERTIFICATE 2024-02-01
171031000629 2017-10-31 CERTIFICATE OF CHANGE 2017-10-31
151222000495 2015-12-22 CERTIFICATE OF AMENDMENT 2015-12-22
20101108032 2010-11-08 ASSUMED NAME CORP INITIAL FILING 2010-11-08
000224000819 2000-02-24 CERTIFICATE OF AMENDMENT 2000-02-24
991215000528 1999-12-15 CERTIFICATE OF AMENDMENT 1999-12-15
970922000275 1997-09-22 CERTIFICATE OF AMENDMENT 1997-09-22
950512000238 1995-05-12 CERTIFICATE OF AMENDMENT 1995-05-12
C094825-4 1990-01-09 CERTIFICATE OF AMENDMENT 1990-01-09
C003093-7 1989-04-25 CERTIFICATE OF AMENDMENT 1989-04-25

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
No data IDV VA528P0260 2007-12-11 No data No data
Unique Award Key CONT_IDV_VA528P0260_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ENDOSCOPY IN BINGHAMTON
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q505: GASTROENTEROLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
DO AWARD V528C84041 2007-12-11 2008-11-30 2008-11-30
Unique Award Key CONT_AWD_V528C84041_3600_VA528P0260_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ENDOSCOPY IN BINGHAMTON
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q505: GASTROENTEROLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
DO AWARD VA528C94268 2009-08-01 2009-09-30 2011-07-31
Unique Award Key CONT_AWD_VA528C94268_3600_VA528P0571_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title GASTRO SUPPORT SERVICES
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q505: GASTROENTEROLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
No data IDV VA528P0571 2009-08-01 No data No data
Unique Award Key CONT_IDV_VA528P0571_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title GASTRO SUPPORT SERVICES
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q505: GASTROENTEROLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
DO AWARD VA528C94030 2008-10-01 2009-05-30 2009-05-30
Unique Award Key CONT_AWD_VA528C94030_3600_VA528P0260_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title GI SERVICES
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q505: GASTROENTEROLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
PO AWARD VA528C94039 2008-10-01 2008-12-31 2008-12-31
Unique Award Key CONT_AWD_VA528C94039_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes C114: HOSPITAL BUILDINGS

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
DO AWARD VA528C04055 2010-07-27 2010-09-30 2011-07-31
Unique Award Key CONT_AWD_VA528C04055_3600_VA528P0571_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title GASTRO SUPPORT SERVICES
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q505: GASTROENTEROLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
PO AWARD VA528C04053 2010-07-01 2010-09-30 2010-09-30
Unique Award Key CONT_AWD_VA528C04053_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title IMAGING SERVICES
NAICS Code 621512: DIAGNOSTIC IMAGING CENTERS
Product and Service Codes Q522: RADIOLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
PO AWARD V528C04053 2009-10-01 2009-12-31 2009-12-31
Unique Award Key CONT_AWD_V528C04053_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title MEDICAL SERVICES
Product and Service Codes Q522: RADIOLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198
PO AWARD VA528C14038 2010-10-01 2011-09-30 2011-09-30
Unique Award Key CONT_AWD_VA528C14038_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title IMAGING
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q522: RADIOLOGY SERVICES

Recipient Details
Recipient OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
UEI MR9LDZZZBZW6
Legacy DUNS 071599021
Recipient Address UNITED STATES, 169 RIVERSIDE DR, BINGHAMTON, 139054198

Trademark

Mark US Serial Number Application Filing Date US Registration Number Registration Date
L 73514007 1984-12-17 1345311 1985-06-25
Trademark image
Register Principal
Mark Type Service Mark
Status Registration cancelled because registrant did not file an acceptable declaration under Section 8. To view all documents in this file, click on the Trademark Document Retrieval link at the top of this page.
Status Date 1991-12-19
Publication Date 1985-04-16
Date Cancelled 1991-12-19

Mark Information
Mark Literal Elements L
Standard Character Claim No
Mark Drawing Type 5 - AN ILLUSTRATION DRAWING WITH WORD(S)/LETTER(S)/NUMBER(S) IN STYLIZED FORM

Goods and Services
For HEALTH CARE SERVICES
International Class(es) 042 - Primary Class
U.S Class(es) 100
Class Status SECTION 8 - CANCELLED
First Use Jul. 01, 1984
Use in Commerce Aug. 01, 1984

Basis Information (Case Level)
Filed Use Yes
Currently Use Yes
Filed ITU No
Currently ITU No
Filed 44D No
Currently 44D No
Filed 44E No
Currently 44E No
Filed 66A No
Currently 66A No
Filed No Basis No
Currently No Basis No

Current Owner(s) Information
Owner Name OUR LADY OF LOURDES MEMORIAL HOSPITAL
Owner Address 169 RIVERSIDE DRIVE BINGHAMTON, NEW YORK UNITED STATES 13905
Legal Entity Type CORPORATION
State or Country Where Organized NEW YORK

Attorney/Correspondence Information
Attorney Name CLIFFORD E. BARNES
Correspondent Name/Address CLIFFORD E BARNES, EPSTEIN BECKER BORSODY & GREEN, PC, 1140 19TH ST N W, WASHINGTON, DISTRICT OF COLUMBIA UNITED STATES 20036

Prosecution History
Date Description
1991-12-19 CANCELLED SEC. 8 (6-YR)
1985-06-25 REGISTERED-PRINCIPAL REGISTER
1985-04-16 PUBLISHED FOR OPPOSITION
1985-03-20 NOTICE OF PUBLICATION
1985-02-19 APPROVED FOR PUB - PRINCIPAL REGISTER
1985-02-15 ASSIGNED TO EXAMINER
1985-02-09 ASSIGNED TO EXAMINER

TM Staff and Location Information
Current Location FILE DESTROYED
Date in Location 1996-11-30

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Date of last update: 22 Dec 2024

Sources: New York Secretary of State

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