# BEAR CREEK PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336150820
- **Authorized official:** LARRY COATS RPH (OWNER)
- **Authorized official phone:** (951) 677-4886

## Contact information

- **Practice address:** 36243 INLAND VALLEY DR, STE 130, WILDOMAR, CA 92595-9549
- **Practice address phone:** (951) 677-4880
- **Practice address fax:** (951) 698-4392
- **Mailing address:** 36243 INLAND VALLEY DR, STE 130, WILDOMAR, CA 92595-9549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | PHY43284 | CA | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0597990 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | PHA432840 | — | CA |