Organization
BEAR CREEK PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY COATS RPH (OWNER)
(951) 677-4886
Entity
Organization
Contact information
Practice address
36243 INLAND VALLEY DR, STE 130, WILDOMAR, CA 92595-9549
(951) 677-4880
(951) 698-4392
Mailing address
36243 INLAND VALLEY DR, STE 130, WILDOMAR, CA 92595-9549
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY43284
CA
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0597990
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA432840
—
CA
Enumeration date
08/10/2006
Last updated
09/11/2025
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