NPIMap

Organization Active NPI

Hartig Drug Co Corp

  • Long Term Care Pharmacy
  • Dubuque, IA
National Provider Identifier
1144327404
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
713 Issued in IA
Legal business name
HARTIG DRUG CO CORP
Practice address
7425 Chavenelle Rd
Suite 300
Dubuque, IA 52002-9674
Phone
(563) 588-8709
Fax
(563) 588-8739
NPI assigned
Sep 20, 2006
Last updated
Aug 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles S Hartig, PHARMD, JDNPI 1568086874
Title
Ceo
Phone
(563) 588-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 713 IA Primary

Addresses

Primary practice location

7425 Chavenelle Rd
Suite 300
Dubuque, IA 52002-9674

Mailing address

703 Main St
Dubuque, IA 52001-6821
Phone (563) 588-8700

Other identifiers 1

IdentifierTypeStateIssuer
1015677MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040331000394 IA Part B Supplier - Mass Immunization (Roster Biller Only) 2365434412 23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dubuque, IA
O20110324000732 IA DME Supplier - Pharmacy 2365434412 Practice locations: Dubuque, IA

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Other NPIs on the same Medicare enrollment 23

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

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hartig Pharmacy Services7425 Chavenelle Rd, Dubuque, IA 52002-9674(563) 588-8709 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Tracheotomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Nebulizer Equipment and/o… Accepts assignmentParticipating since Nov 1, 2007

National Provider Directory

National Provider Directory
Tax ID family
Hartig Drug Co Corp24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Thornton Manor Nursing and Care CenterLansing, IA, CCN 165259 Skilled nursing facility Adp of the SNF Feb 7, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1144327404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016821",
            "telephone_number": "563-588-8700",
            "fax_number": "563-588-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 CHAVENELLE RD",
            "address_2": "SUITE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520029674",
            "telephone_number": "563-588-8709",
            "fax_number": "563-588-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTIG DRUG CO CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "HARTIG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-588-8700",
        "authorized_official_credential": "PHARMD, JD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IA",
            "license": "713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015677",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.