Sai Bear Creek Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

SAI BEAR CREEK PHARMACY LLC

Practice address

24046 Clinton Keith Rd
Suite 107
Wildomar, CA 92595

Phone

(951) 677-4880

Fax

(951) 698-4392

NPI assigned

May 18, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Saisatish Gunda

Title

Managing Member

Phone

(951) 677-4880

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• bear creek pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Farmacia del Pueblo4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Reliance Best Pharmacy LLC

  • Long Term Care Pharmacy
  • Brawley, CA
  • NPI 1205728375
  NPD tax ID
• Reliance Best Pharmacy LLC

  • Community/Retail Pharmacy
  • Brawley, CA
  • NPI 1467887000
  NPD tax ID
• Reliance Best Pharmacy LLC

  • Community/Retail Pharmacy
  • Sun City, CA
  • NPI 1770718041
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kiran Nagaraja

  • Pharmacist
  • Wildomar, CA
  • NPI 1770304917
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1043445208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24046 CLINTON KEITH RD",
            "address_2": "SUITE 107",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "92595",
            "telephone_number": "951-677-4880",
            "fax_number": "951-698-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24046 CLINTON KEITH RD",
            "address_2": "SUITE 107",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "92595",
            "telephone_number": "951-677-4880",
            "fax_number": "951-698-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAI BEAR CREEK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "GUNDA",
        "authorized_official_first_name": "SAISATISH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "951-677-4880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "50678",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131358",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043445208",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "bear creek pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "bear creek pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Terry Joe Rushing Jr.
• Samantha Ruvalcaba
• Sierra Ruvalcaba
• Kerri Michelle Ryan
• Stephanie Lake Sadaka
• Sai Bear Creek Pharmacy LLC
• Marc Todd Sakoda, D.C.
• Matthew Salanoa
• Amber Nicole Salgado, LVN
• Shelby Sanabria, RBT

• Pharmacy in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.