Provider Demographics
NPI:1881864494
Name:CSRX, INC.
Entity Type:Organization
Organization Name:CSRX, INC.
Other - Org Name:MEDICINE SHOPPE ADVANCED CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:RISING
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:605-348-2500
Mailing Address - Street 1:1304 MOUNT RUSHMORE RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-3667
Mailing Address - Country:US
Mailing Address - Phone:605-348-2500
Mailing Address - Fax:605-348-2622
Practice Address - Street 1:5626 FARGO LANE
Practice Address - Street 2:STE 104
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4645
Practice Address - Country:US
Practice Address - Phone:605-348-2500
Practice Address - Fax:605-348-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY138349Medicaid
ND21503Medicaid
SD8504500Medicaid
SD9162840Medicaid
SD4354091OtherNCPDP
SD8504500Medicaid
WY138349Medicaid
SD8504500Medicaid