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Hartig Drug Co Corp

Organization Active NPI Community/Retail Pharmacy · Prophetstown, IL

NPI 1902903560 · NPPES record last updated Aug 5, 2021

Key facts

NPI
1902903560
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
054-15922 (IL)
Legal business name
HARTIG DRUG CO CORP
Practice address
316 Washington St
Prophetstown, IL 61277-1184
Phone
(815) 537-2400
Fax
(815) 537-2404
NPI assigned
Sep 17, 2006
Organization subpart
No

Authorized official

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.

Other NPIs with the same Medicare PAC ID 23

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

Corporate family (same tax ID) 23

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

Member of 1

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

Practitioners 4

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

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hartig Drug Co Corp
316 Washington St, Prophetstown, IL 61277-1184 · (815) 537-2400		 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 assignment
Participating since Nov 1, 2007

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in IA, IL

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 Center
Lansing, IA · CCN 165259		 Skilled nursing facility Adp of the SNF Feb 7, 2020

Medicare enrollment records

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
O20100301000354 IL Part B Supplier - Mass Immunization (Roster Biller Only) 2365434412 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Savanna, IL; Stockton, IL; Prophetstown, IL; Galena, IL
O20100930096377 IL DME Supplier - Pharmacy 2365434412 Practice locations: Prophetstown, IL

National Provider Directory

Tax ID family
Hartig Homecare Nursing (24 organizations share this tax ID)

Locations

316 Washington St
#318
Prophetstown, IL 61277

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054-15922 IL Yes

Addresses

Primary practice location

316 Washington St
Prophetstown, IL 61277-1184

Mailing address

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

Other providers in Prophetstown, IL

All providers in Prophetstown, IL · Community/Retail Pharmacy in Illinois

Sources for this page

Verify at the official NPI Registry.