Bear Creek Pharmacy

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

BEAR CREEK PHARMACY

Practice address

36243 Inland Valley Dr
Ste 130
Wildomar, CA 92595-9549

Phone

(951) 677-4880

Fax

(951) 698-4392

NPI assigned

Aug 10, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Larry Coats, RPH

Title

Owner

Phone

(951) 677-4886

Specialties & licenses 3

Addresses

Other identifiers 2

Tax ID family

Bear Creek Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Bear Creek Pharmacy LTC

  • Pharmacist
  • Wildomar, CA
  • NPI 1710100359
  NPD tax ID

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1336150820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR",
            "address_2": "STE 130",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR",
            "address_2": "STE 130",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959549",
            "telephone_number": "951-677-4880",
            "fax_number": "951-698-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR CREEK PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "COATS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-677-4886",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY43284",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0597990",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA432840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alejandra Barwin
• Tanya Bassig
• Josiah Baxter
• Bear Creek Chiropractic
• Bear Creek Eye Care Optometry
• Bear Creek Pharmacy LTC
• Kassandra Beauchamp
• Jennifer E Beck Ruth
• Ashaunte Bedford
• Candice Belgarde

• Long Term Care Pharmacy in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.