A bit confusing, but based on my interpretation you'll need an append query for each "set" of csv fields that need to go into the final tables. So 1 query to get records into tblPharmacy and another for tblDispenser. However, you must include the fk from the csv table each time you append to a table that's related to some other append you did; e.g. PharmacyID goes in to tblPharmacy (from csv table) but also PharmacyID in to tblDispenser. If you must create a partial record in a table and other fields will come from other portions of the csv file and cannot be written at the same time, you'd do the same as above but with an update query to fill in the missing fields.
The more we hear silence, the more we begin to think about our value in this universe.
Paraphrase of Professor Brian Cox.