NPIMap

Individual provider Active NPI

Charles Hartig, PHARMD

  • Pharmacist
  • Dubuque, IA
National Provider Identifier
1568086874
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21040 Issued in IA
Practice address
157 Locust St
Dubuque, IA 52001-7660
Phone
(563) 588-8702
NPI assigned
Jun 2, 2020
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21040 IA Primary

Addresses

Primary practice location

157 Locust St
Dubuque, IA 52001-7660

Mailing address

703 Main St
Dubuque, IA 52001-6814
Phone (563) 588-8700

Other identifiers 3

IdentifierTypeStateIssuer
15704-040OtherWIPHARMACIST LICENSE
21040OtherIAPHARMACIST LICENSE
051293969OtherILPHARMACIST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
21040IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
LTC Pharmco LLC Current Accepting new patients
LTC Pharmco LLC Current Accepting new patients
Hartig Drug Co Corp PastSince Jun 7, 2020 Accepting new patients
Hartig Drug Co Corp PastSince Jun 7, 2020 Accepting new patients

Locations

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

Organizations & group practices 27

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1568086874",
    "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": "520016814",
            "telephone_number": "563-588-8700"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTIG",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "21040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "15704-040",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "21040",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "051293969",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.