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Contact Information

CUSTER COMMUNITY PHARMACY LLC
521 MOUNT RUSHMORE RD
CUSTER, SD57730-1531
 Phone: 605-673-2225
 Fax: 605-673-3577
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CUSTER COMMUNITY PHARMACY LLC

NPI Number 1154460996
LBN Legal business name CUSTER COMMUNITY PHARMACY LLC
Authorized official DILLON KJERSTAD - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2007
Last updated 11/30/2023 - About 3 years ago
Identifiers
SD License # 1002051
SD Medicaid 1154460996
Other 2175295 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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