Organization
SAI BEAR CREEK PHARMACY LLC
Active
Other names
bear creek pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAISATISH GUNDA (MANAGING MEMBER)
(951) 677-4880
Entity
Organization
Contact information
Practice address
24046 CLINTON KEITH RD, SUITE 107, WILDOMAR, CA 92595
(951) 677-4880
(951) 698-4392
Mailing address
24046 CLINTON KEITH RD, SUITE 107, WILDOMAR, CA 92595
(951) 677-4880
(951) 698-4392
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
50678
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043445208
—
CA
01
—
2131358
PK
—
Enumeration date
05/18/2009
Last updated
03/03/2023
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