NPIMap

Organization Active NPI

Hartig Drug Co Corp

  • Community/Retail Pharmacy
  • Dubuque, IA
National Provider Identifier
1356448914
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
788 Issued in IA
Legal business name
HARTIG DRUG CO CORP
Practice address
157 Locust St
Dubuque, IA 52001-7660
Phone
(563) 588-8702
Fax
(563) 588-8751
NPI assigned
Sep 17, 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 connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 788 IA Primary

Addresses

Primary practice location

157 Locust St
Dubuque, IA 52001-7660

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0016832MedicaidIA

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
O20100930067516 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 Drug Store 2157 Locust St, Dubuque, IA 52001-7660(563) 588-8702 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

National Provider Directory

National Provider Directory
Tax ID family
Hartig Drug Co24 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 3

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": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1356448914",
    "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": "157 LOCUST ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520017660",
            "telephone_number": "563-588-8702",
            "fax_number": "563-588-8751"
        }
    ],
    "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": "IA",
            "license": "788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016832",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.