Background Few studies have documented rural community pharmacy disaster preparedness. Objectives To: (1) describe rural community pharmacies’ preparedness for and responses to COVID-19 and (2) examine whether responses vary by level of pharmacy rurality. Methods A convenience sample of rural community pharmacists completed an online survey (62% response rate) that assessed: (a) demographic characteristics; (b) COVID-19 information source use; (c) interest in COVID-19 testing; (d) infection control procedures; (e) disaster preparedness training, and (f) medication supply impacts. Descriptive statistics were calculated and differences by pharmacy rurality were explored. Results Pharmacists used the CDC (87%), state health departments (77%), and state pharmacy associations (71%) for COVID-19 information, with half receiving conflicting information. Most pharmacists (78%) were interested in offering COVID-19 testing but needed personal protective equipment and training to do so. Only 10% had received disaster preparedness training in the past five years. Although 73% had disaster preparedness plans, 27% were deemed inadequate for the pandemic. Nearly 70% experienced negative impacts in medication supply. There were few differences by rurality level. Conclusion Rural pharmacies may be better positioned to respond to pandemics if they had disaster preparedness training, updated disaster preparedness plans, and received regular policy guidance from professional bodies.

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