Petra Pharmacy Corp
NPI 1104901131 · Community/Retail Pharmacy · San Jacinto, CA
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Petra Pharmacy Corp is a Community/Retail Pharmacy organization in San Jacinto, CA (NPI 1104901131).
Provider details
- NPI number
- 1104901131
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Linda Rabadi, Cfo(951) 654-2791
Specialties & taxonomies
Suppliers
- Home Infusion Therapy Pharmacy3336H0001X
Suppliers
- Long Term Care Pharmacy3336L0003X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Enova Care Pharmacy
- Doing business as
- Medicine Shoppe
Registry dates
- Enumerated
- 2006-10-26
- Last updated
- 2026-03-23
- Certified
- 2026-03-23
Frequently asked questions
- What is Petra Pharmacy Corp's NPI number?
- Petra Pharmacy Corp's National Provider Identifier (NPI) is 1104901131, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Petra Pharmacy Corp?
- Petra Pharmacy Corp is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Petra Pharmacy Corp located?
- Petra Pharmacy Corp's practice location on file with NPPES is 1477 S San Jacinto Ave, San Jacinto, CA 92583-5105.
- What is Petra Pharmacy Corp's phone number?
- The practice phone number listed in the NPPES registry for Petra Pharmacy Corp is (951) 927-5710.
- Does Petra Pharmacy Corp accept Medicare?
- Petra Pharmacy Corp is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Petra Pharmacy Corp?
- The authorized official listed on Petra Pharmacy Corp's NPPES record is Linda Rabadi, Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Petra Pharmacy Corp's NPI active?
- Yes — Petra Pharmacy Corp's NPI (1104901131) is active in the NPPES registry as of the last update on 2026-03-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.