Healthcare Provider Details

I. General information

NPI: 1417054776
Provider Name (Legal Business Name): HARTIG DRUG CO CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 CENTRAL AVE
DUBUQUE IA
52001-3506
US

IV. Provider business mailing address

703 MAIN ST
DUBUQUE IA
52001-6821
US

V. Phone/Fax

Practice location:
  • Phone: 563-588-8704
  • Fax: 563-588-8759
Mailing address:
  • Phone: 563-588-8700
  • Fax: 563-588-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number782
License Number StateIA

VIII. Authorized Official

Name: CHARLES S HARTIG
Title or Position: CEO
Credential: PHARMD, JD
Phone: 563-588-8700