Where the pharmacies are not

This is not a new problem, and the count here agrees with the work before it. The Rural Policy Research Institute found 138 counties with no retail pharmacy in 2021. In April 2026, MedPAC reported that pharmacy closures rose from 1,764 in 2021 to 3,929 in 2025, and that the share of Part D prescriptions filled by mail stayed near 15% through those years. Mail's share did not grow as the stores closed.

What this page adds is the next list: the 394 counties one closure away from none, each with the name of the store that stands between its residents and the nearest pharmacy, and whether that store is already on the Team Cuban Card locator.

394 counties have exactly one open retail pharmacy. 2,557,998 people live in them. 41 of those stores are on the Team Cuban Card locator. 353 are not. In 31 of the 394 counties, the last pharmacy is run by the local hospital or hospital district. 8 of those are in Texas, where county hospital districts run them.

Read 394 as a close count, not an exact one. In 175 of the 394 counties, the registry also lists a second store that no Medicare network confirms. Most such stores have closed. We checked the 40 most populous of the 394 by hand: 26 have exactly one open pharmacy, none has more than one, and 14 turn on a small store we could not confirm open or closed. The table marks every county with a second store like this.

Search by county, state or store. "Nearest network pharmacy" is the straight-line distance from the store to the closest pharmacy on the Team Cuban Card locator.

145 counties have no open retail pharmacy. 563,525 people live in them. For half of these counties, the nearest Team Cuban Card pharmacy is more than 35.1 miles from where most residents live. For 43 counties it is more than 50 miles.

13 of the 145 have a tribal or Indian Health Service pharmacy. Those serve tribal members and other eligible patients, not every resident, so they are shown but not counted as retail. The registry shows a pharmacy in 30 of the 145 counties; each of those stores was checked, and the table says what we found. Most had closed. We also checked by hand the 25 most populous of the counties where the registry shows nothing: 24 have no open pharmacy, and one, Dallam County, Texas, turns on a store in Dalhart we could not confirm open or closed.

The risk is highest where a county has one pharmacy or none and many households have no vehicle. 44 counties have one or none and 10% or more of households without a car. 252,856 people live in them. 14 are in Alaska, where most villages have no road out. 7 are in South Dakota, all of them counties that include reservation land. Most of the rest are in the rural South: Georgia, Texas, Alabama, Mississippi and Tennessee.

All 3,144 counties. "Open" is the count this page uses: in a Medicare retail network, or confirmed open by hand. "Registry" is every retail storefront on the federal registry, including closed stores; it is shown so you can see the gap. 119 counties have no registry pharmacy at all.

• Pharmacies: every active organization in the federal NPPES registry with a pharmacy taxonomy (3336xx) in any of its 15 slots, from the Verzi Health data API (/rx/pharmacies), pulled October 7, 2026. Retail means community or retail pharmacy, clinic pharmacy, or the unspecified pharmacy code. Some open stores file under a pharmacist code instead; those were added from the Medicare file below.
• Storefront: one street address. Two records at the same address count once.
• Open: at least one record at the address is in a Medicare Part D plan's retail pharmacy network in CMS's monthly formulary and pharmacy network file of September 16, 2026, or we confirmed the store open by hand (store locator, recent listings, or state board license), with the evidence recorded. Veterans Affairs, military, tribal and Indian Health Service pharmacies, dispensing physicians and other dispensing sites also appear in Part D networks; they are not counted as retail.
• County: the store's street address, placed by the Census Bureau geocoder, or by OpenStreetMap when the Census geocoder found no match. 36 network pharmacies have only a post office box or single-building ZIP and could not be placed; all are in counties with many pharmacies.
• Population, vulnerability, vehicle access and insurance: CDC Social Vulnerability Index 2022 (ACS 2018 to 2022). Centers of population: Census 2020.
• Team Cuban Card locator: the public pharmacy locator at teamcubancard.com/locator, queried October 7, 2026. A last pharmacy counts as on the locator when the locator lists the same NPI, or a locator pharmacy within 0.15 miles of its address. The locator listed about 9,600 locations; Cost Plus has described the network as nearly 18,000 pharmacies. Cost Plus confirmed that the public locator does not list the whole network, so some stores marked "not on the locator" are likely in the network. The locator column shows only what a patient sees on the public locator.

What this can and cannot say. A pharmacy outside every Medicare network can still be open, for example a cash-only store, so the open count can miss a few; we checked by hand every store in the counties where that would change the answer. A county line is not a travel distance: some residents of a county with no pharmacy live a few miles from one across the line, and some residents of a county with one live 60 miles from it. The vulnerability index is a county average. Store closures are not counted directly, because the registry erases a closed store's details. The Team Cuban Card locator changes as pharmacies join, so the locator figures are as of October 7, 2026. Nothing here describes the quality of any pharmacy.