Provider Demographics
NPI:1316256431
Name:HARTIG DRUG CO CORP
Entity type:Organization
Organization Name:HARTIG DRUG CO CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARTIG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, JD
Authorized Official - Phone:563-588-8700
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6814
Mailing Address - Country:US
Mailing Address - Phone:563-588-8700
Mailing Address - Fax:563-588-8750
Practice Address - Street 1:327 MAIN ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53530-1425
Practice Address - Country:US
Practice Address - Phone:608-776-4481
Practice Address - Fax:608-776-2341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1316256431Medicaid
WI0243710019Medicare NSC
WIWI1554Medicare PIN