Individual provider Active NPI

Jeffrey Charles Hartwig

  • Pharmacist
  • Norwich, NY
National Provider Identifier
1730484189
Registry record updated Jan 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
055393-01 Issued in NY
Practice address
5396 State Highway 12
Norwich, NY 13815-3716
Phone
(607) 334-6029
NPI assigned
Jan 17, 2011
Last updated
Jan 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 055393-01 NY Primary

Addresses

Primary practice location

5396 State Highway 12
Norwich, NY 13815-3716

Mailing address

PO Box 114
Lee Center, NY 13363-0114
Phone (607) 341-8433

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

State licenses

LicenseStateTypeSpecialty
055393-01NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295222400000",
    "number": "1730484189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 114",
            "city": "LEE CENTER",
            "state": "NY",
            "postal_code": "133630114",
            "telephone_number": "607-341-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5396 STATE HIGHWAY 12",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "138153716",
            "telephone_number": "607-334-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTWIG",
        "first_name": "JEFFREY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-17",
        "last_updated": "2011-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "055393-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2011; 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.