Healthcare Provider Details

I. General information

NPI: 1245637529
Provider Name (Legal Business Name): HARTIG DRUG CO CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 COURT STREET
WILLIAMSBURG IA
52361
US

IV. Provider business mailing address

517 COURT STREET
WILLIAMSBURG IA
52361
US

V. Phone/Fax

Practice location:
  • Phone: 319-668-1520
  • Fax: 319-668-8178
Mailing address:
  • Phone: 319-668-1520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1515
License Number StateIA

VIII. Authorized Official

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