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Contact Information

SAI BEAR CREEK PHARMACY LLC
24046 CLINTON KEITH RD
SUITE 107
WILDOMAR, CA92595
 Phone: 951-677-4880
 Fax: 951-698-4392
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SAI BEAR CREEK PHARMACY LLC

NPI # 1043445208
LBN Legal business name SAI BEAR CREEK PHARMACY LLC
Authorized official SAISATISH GUNDA - (MANAGING MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/18/2009
Last updated 03/03/2023 - About 3 years ago
Identifiers
CA License # 50678
CA Medicaid 1043445208
Other 2131358 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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