Bear Creek Pharmacy LTC
Organization Active NPI Pharmacist · Wildomar, CA
NPI 1710100359 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1710100359
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- PHY47553 (CA)
- Legal business name
- BEAR CREEK PHARMACY LTC
- Practice address
- 36243 Inland Valley Drive
Suite 150
Wildomar, CA 92595 - Phone
- (951) 677-5220
- Fax
- (951) 677-1149
- NPI assigned
- Apr 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Larry Joseph Coats, PHARM D
- Title
- Owner
- Phone
- (951) 677-5220
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Bear Creek Pharmacy
Locations
36243 Inland Valley Dr
Ste 150
Wildomar, CA 92595
Phone (951) 677-5220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | PHY47553 | CA | Yes |
Addresses
Primary practice location
36243 Inland Valley Drive
Suite 150
Wildomar, CA 92595
Mailing address
36243 Inland Valley Drive
Suite 150
Wildomar, CA 92595
Phone (951) 677-5220
Other providers in Wildomar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.