Organization
CUSTER COMMUNITY PHARMACY LLC
Active
Other names
Carson Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DILLON KJERSTAD (PRESIDENT)
(605) 270-7609
Entity
Organization
Contact information
Practice address
521 MOUNT RUSHMORE RD, CUSTER, SD 57730-1531
(605) 673-2225
(605) 673-3577
Mailing address
PO BOX 878, PHILIP, SD 57567-0878
(605) 270-7609
(605) 859-3026
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1002051
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154460996
—
SD
01
—
2175295
PK
—
Enumeration date
02/06/2007
Last updated
11/30/2023
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