Petra Pharmacy Corp in San Jacinto - Home Infusion
Petra Pharmacy Corp - NPI 1104901131
Petra Pharmacy Corp is a Home Infusion in San Jacinto, California. Petra Pharmacy Corp practices all healthcare services and medical treatments related to Home Infusion. The NPI Number for Petra Pharmacy Corp is 1104901131. The last update date is 2023-06-23.
Petra Pharmacy Corp's current location address is 1477 S San Jacinto Ave, San Jacinto, California. You can contact this provider via phone number 9519275710 and fax number 9519279834. The mailing address for Petra Pharmacy Corp is 1477 S San Jacinto Ave, San Jacinto, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Petra Pharmacy Corp |
|---|---|
| Address | 1477 S San Jacinto Ave, San Jacinto, California |
| Phone Number | 9519275710 |
| Fax Number | 9519279834 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | AO |
|---|---|
| Authorized Official Name | Alfakhouri Awni |
| Telephone Number | 9516542791 |
NPI Number Detail
| NPI Number | 1104901131 |
|---|---|
| Provider Enumeration Date | 2006-10-26 |
| Last Updated Date | 2023-06-23 |
Provider Mailing Address Detail
| Address | 1477 S San Jacinto Ave |
|---|---|
| City | San Jacinto |
| State | California (CA) |
| Post Code | 925835105 |
| Phone Number | 9519275710 |
| Fax Number | 9519279834 |
Provider's Primary Taxonomy Detail
| Speciality | Home Infusion |
|---|---|
| Taxonomy | 251F00000X |
|
Definition: Provides fluids, nutrition, medication and related infusion services to patients in their homes. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PHA546020 | CA | -- | |
| 1104901131 | CA | NPI | |
| 574271 | CA | NCPDP # | |
| PHY54602 | CA | PHARMACY PERMIT |
Post Comment/ Review Below
What is the unique identifier code issued to Petra Pharmacy Corp by the Centers for Medicare & Medicaid Services?
The Petra Pharmacy Corp has been assigned the NPI (National Provider Identifier) 1104901131. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Petra Pharmacy Corp's physical address?
The Petra Pharmacy Corp is physically located at 1477 S San Jacinto Ave, in the city of San Jacinto, CA, with the postal code 925835105.
What is Petra Pharmacy Corp's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Petra Pharmacy Corp is Home Infusion, and the corresponding taxonomy classification code for this specialized field is 251F00000X.
When did the Petra Pharmacy Corp receive its 1104901131?
The Petra Pharmacy Corp was issued its 1104901131 on 2006-10-26, which is the date when the organization was assigned this unique identifier.
When was the information regarding Petra Pharmacy Corp, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Petra Pharmacy Corp, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2023-06-23.
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