BEAR CREEK PHARMACY LTC (NPI# 1710100359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710100359 |
| Entity Type | Organization |
| Organization Name | BEAR CREEK PHARMACY LTC |
| Practice Address |
36243 Inland Valley Drive Suite 150 Wildomar CA 92595 |
| Practice Telephone | 9516775220 |
| Practice Fax Number | 9516771149 |
| Mailing Telephone | 9516775220 |
| Mailing Fax Number | 9516771149 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. LARRY JOSEPH COATS (OWNER) |
| Authorized Official Telephone | 9516775220 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PHY47553 | CA | Pharmacy Service Providers |
| Street Address |
36243 INLAND VALLEY DRIVE SUITE 150 |
| City | WILDOMAR |
| State | CA |
| Zip Code | 92595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023054269 | Purnima K Patel | Internal Medicine | 36243 Inland Valley Drive, Suite 160, Wildomar, CA 92595-9548 | 2006-06-22 |
| 1598849374 | Ricky A Oldenburg | Physician Assistant | 36243 Inland Valley Drive, Suite 180, Wildomar, CA 92595 | 2006-10-25 |
| 1689758468 | Ernest V Juarez | Physician Assistant | 36243 Inland Valley Drive, Suite 180, Wildomar, CA 92595 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184190845 | Amber Nicole Salgado | Licensed Vocational Nurse | 33685 Harvest Way East, Wildomar, CA 92595 | 2018-10-22 |
| 1417448168 | Inland Valley Trauma and Acute Care Surgery Apc Inc | Surgery | 36320 Inland Valley Dr Ste 101a, Wildomar, CA 92595 | 2018-05-29 |
| 1033636311 | Omar H Nael | Behavioral Analyst | 35925 Susan Dr, Wildomar, CA 92595 | 2017-08-27 |
| 1023535820 | Dennis Bonavilla | Specialist/Technologist, Other | 34859 Frederick Street, Suite 112, Wildomar, CA 92595 | 2017-08-23 |
| 1578965901 | Purnima K Patel M.d Inc | Internal Medicine | 32423 Inland Valley Dr. Ste 160, Wildomar, CA 92595 | 2014-09-17 |
| 1740523133 | Jerry Zhong Yu | Internal Medicine | 36320 Inland Valley Dr Ste 308, Wildomar, CA 92595 | 2013-04-03 |
| 1871859553 | Norman Orr | Internal Medicine | 36485 Valley Medical Center, Wildomar, CA 92595 | 2012-04-06 |
| 1902190226 | Brian Patrick Tiu | Surgery | 36320 Inland Valley Dr Ste 101, Wildomar, CA 92595 | 2011-06-03 |
| 1508013897 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 24335 Prielipp Rd Bldg A, Ste 116, Wildomar, CA 92595 | 2008-08-19 |
| 1760604383 | Nasko Lubenov Atanassov | Physical Therapist | 36485 Inland Valey Drive, Wildomar, CA 92595 | 2007-05-03 |
| Find all providers in zip 92595 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336468610 | Tommy Tuan Nguyen | Pharmacist | 32450 Clinton Keith Rd, Wildomar, CA 92595-7312 | 2010-05-25 |
| 1881911170 | John Ippolito | Pharmacist | 36010 Hidden Springs Rd, Wildomar, CA 92595-7622 | 2010-04-26 |
| 1427209162 | Giang Thanh Nguyen | Pharmacist | 35683 Verde Vista Way, Wildomar, CA 92595-7524 | 2008-09-30 |
| 1477071934 | Rim Al Asaf | Pharmacist | 32450 Clinton Keith Rd, Wildomar, CA 92595-7312 | 2017-09-05 |
| 1568901833 | Pamela Warmington | Pharmacist | 36450 Inland Valley Dr, Suite 209, Wildomar, CA 92595-9583 | 2017-02-19 |
| 1407395866 | Jeffrey Labandelo Fajardo | Pharmacist | 36450 Inland Valley Dr, Wildomar, CA 92595-9583 | 2017-02-18 |
| 1114466653 | Bassam Azzam | Pharmacist | 36450 Inland Valley Dr, Wildomar, CA 92595 | 2017-02-16 |
| 1386182285 | Dante Gibson | Pharmacist | 36450 Inland Valley Dr, Suite #209, Wildomar, CA 92595-9583 | 2017-02-10 |
| 1912445818 | David Chen | Pharmacist | 36450 Inland Valley Dr, Wildomar, CA 92595-9583 | 2017-02-10 |
| 1245614502 | Yalda Lynn Howard | Pharmacist | 36450 Inland Valley Dr, Wildomar, CA 92595-9583 | 2015-07-16 |
| Find all providers in WILDOMAR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.