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  5. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.

OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.

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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

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

Unique Entity ID

Unique Entity ID:
MR9LDZZZBZW6
CAGE Code:
49KV4
UEI Expiration Date:
2025-10-31

Business Information

Division Name:
YOUTH SERVICES
Activation Date:
2024-11-04
Initial Registration Date:
2006-01-18

Commercial and government entity program

CAGE number:
49KV4
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2025-05-13
SAM Expiration:
2025-10-31

Contact Information

POC:
FRAN MACAFEE

National Provider Identifier

NPI Number:
1730982596
Certification Date:
2025-06-23
Link:
View on NPI website

Authorized Person:

Name:
SHAYNE WILCOX
Role:
OUTPATIENT PHARMACY MANAGER
Phone:
6077985911

Taxonomy:

Selected Taxonomy:
3336S0011X - Specialty Pharmacy
Is Primary:
Yes

Contacts:

Phone:
+1 607-798-5533
Fax:
6077985534

Form 5500 Series

Employer Identification Number (EIN):
150532221
Plan Year:
2012
Number Of Participants:
1672
Sponsors Telephone Number:
6075849459
File:
View File
Plan Year:
2011
Number Of Participants:
2289
Sponsors Telephone Number:
6075849459
File:
View File
Plan Year:
2011
Number Of Participants:
1753
Sponsors Telephone Number:
6075849459
File:
View File
Plan Year:
2010
Number Of Participants:
1535
Sponsors Telephone Number:
6075849459
File:
View File
Plan Year:
2010
Number Of Participants:
2126
Sponsors Telephone Number:
6075849459
File:
View File

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

USAspending Awards / Contracts

Procurement Instrument Identifier:
36C24218N0051
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
-1017.85
Base And Exercised Options Value:
-1017.85
Base And All Options Value:
-1017.85
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2018-03-12
Description:
IGF::OT::IGF - RADIOLOGY SERVICES TO SUPPORT BINGHAMTON CBOC.
Naics Code:
621512: DIAGNOSTIC IMAGING CENTERS
Product Or Service Code:
Q522: MEDICAL- RADIOLOGY
Procurement Instrument Identifier:
VA24217J0001
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
-10840.00
Base And Exercised Options Value:
-10840.00
Base And All Options Value:
-10840.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2017-08-31
Description:
IGF::OT::IGF - RADIOLOGY SERVICES TO SUPPORT BINGHAMTON CBOC.
Naics Code:
621512: DIAGNOSTIC IMAGING CENTERS
Product Or Service Code:
Q522: MEDICAL- RADIOLOGY
Procurement Instrument Identifier:
VA52816J0006
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
-4832.64
Base And Exercised Options Value:
-4832.64
Base And All Options Value:
-4832.64
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2016-08-03
Description:
IGF::OT::IGF - RADIOLOGY SERVICES TO SUPPORT BINGHAMTON CBOC. FUNDING FOR FY 2016
Naics Code:
621512: DIAGNOSTIC IMAGING CENTERS
Product Or Service Code:
Q522: MEDICAL- RADIOLOGY

USAspending Awards / Financial Assistance

Date:
2018-02-08
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
MINORITY YOUTH VIOLENCE PREVENTION PROGRAM
Obligated Amount:
-223587.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2016-07-29
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
MINORITY YOUTH VIOLENCE PREVENTION PROGRAM
Obligated Amount:
753021.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2014-09-25
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
MINORITY YOUTH VIOLENCE PREVENTION PROGRAM
Obligated Amount:
976608.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2008-07-11
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
HEALTH CARE AND OTHER FACILITIES
Obligated Amount:
331692.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2008-09-08
Link:
View on USAspending
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
2004 AFL ABSTINENCE EDUCATION PREVENTION GRANTS; HELPING OUR PARENTS TO BE EDUCATORS - HOPE PROJECT
Obligated Amount:
435831.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Trademarks Section

Serial Number:
73514007
Mark:
L
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.
Mark Type:
Service Mark
Application Filing Date:
1984-12-17
Mark Drawing Type:
5 - AN ILLUSTRATION DRAWING WITH WORD(S)/LETTER(S)/NUMBER(S) IN STYLIZED FORM
Mark Literal Elements:
L
USPTO Link:
View Trademark Status and Document Retrieval (TSDR)

Goods And Services

For:
HEALTH CARE SERVICES
First Use:
1984-07-01
International Classes:
042 - Primary Class
Class Status:
SECTION 8 - CANCELLED

OSHA's Inspections within Industry

Inspection Summary

Date:
2022-03-11
Type:
FollowUp
Address:
169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Safety Health:
Health
Scope:
Partial

Inspection Summary

Date:
2021-01-13
Type:
Complaint
Address:
169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Safety Health:
Health
Scope:
Partial

Inspection Summary

Date:
2020-11-04
Type:
Fat/Cat
Address:
415 EAST MAIN STREET, ENDICOTT, NY, 13760
Safety Health:
Health
Scope:
Partial

Inspection Summary

Date:
2020-03-04
Type:
Complaint
Address:
169 RIVERSIDE DRIVE, BINGHAMTON, NY, 13905
Safety Health:
Safety
Scope:
Partial

Tax Exempt

Employer Identification Number (EIN) :
15-0532221
In Care Of Name:
% SEAN MONAHAN CPA
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2024-12
National Taxonomy Of Exempt Entities:
Health Care: Hospital, General
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Motor Carrier Census

Carrier Operation:
Interstate
Phone:
(607) 798-5576
Email:
JACOB.SIMMONS@GUTHRIE.ORG
Add Date:
2011-03-22
Operation Classification:
Private(Property)
power Units:
6
Drivers:
5
Inspections:
0
FMCSA Link:
View on FMCSA website

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State

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