Healthcare Provider Details

I. General information

NPI: 1023489101
Provider Name (Legal Business Name): CSRX INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 MOUNT RUSHMORE RD
RAPID CITY SD
57701-3667
US

IV. Provider business mailing address

1308 MOUNT RUSHMORE RD
RAPID CITY SD
57701-3667
US

V. Phone/Fax

Practice location:
  • Phone: 605-721-0831
  • Fax: 605-716-7984
Mailing address:
  • Phone: 605-721-0831
  • Fax: 605-716-7984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number100-2032
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CURTIS DALE RISING
Title or Position: PHARMACIST OWNER
Credential: PHARM. D
Phone: 605-721-0831