NPIMap

Organization Active NPI

Hartig Drug Co Corp

  • Community/Retail Pharmacy
  • Fennimore, WI
National Provider Identifier
1316044985
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8388-042 Issued in WI
Legal business name
HARTIG DRUG CO CORP
Practice address
1120 Lincoln Ave
Fennimore, WI 53809-1746
Phone
(608) 822-3601
Fax
(608) 822-3663
NPI assigned
Sep 17, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Charles S Hartig, PHARMD, JD
Title
Ceo
Phone
(563) 588-8700

Owned or controlled facilities with NPI records 1

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

Other NPIs on the same Medicare enrollment 24

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

View all 24

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

Member of 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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 Drug Co Corp1120 Lincoln Ave, Fennimore, WI 53809-1746(608) 822-3601 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|Nebulizer Equipment and/or Supplies|Surgical Dressings|Diab… Accepts assignmentParticipating since Nov 1, 2007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI3 enrollments

Enrollment records 3

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
O20100301000269 WI Part B Supplier - Mass Immunization (Roster Biller Only) 2365434412 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Prairie Du Chien, WI; Platteville, WI; Fennimore, WI; Lancaster, WI; Darlington, WI
O20100930062208 WI DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 2365434412 Practice locations: Fennimore, WI

All facility ownership & control disclosures 1

Medicare enrollment files

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

National Provider Directory

National Provider Directory
Tax ID family
Hartig Homecare Nursing24 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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 8388-042 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

1120 Lincoln Ave
Fennimore, WI 53809-1746

Mailing address

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

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
33273900MedicaidWI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2021.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1316044985",
    "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": "1120 LINCOLN AVE",
            "city": "FENNIMORE",
            "state": "WI",
            "postal_code": "538091746",
            "telephone_number": "608-822-3601",
            "fax_number": "608-822-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTIG DRUG CO CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8388-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33273900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fennimore, WI

Sources for this page

Verify at the official NPI Registry.