Provider Demographics
NPI:1912992884
Name:TRINITY WEST PHARMACY
Entity Type:Organization
Organization Name:TRINITY WEST PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKET DIRECTOR OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD,MBA,DPLA
Authorized Official - Phone:740-264-8669
Mailing Address - Street 1:4000 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2300
Mailing Address - Country:US
Mailing Address - Phone:740-264-8663
Mailing Address - Fax:740-264-8612
Practice Address - Street 1:4000 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2300
Practice Address - Country:US
Practice Address - Phone:740-264-8663
Practice Address - Fax:740-264-8612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-035900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3655632OtherNAT ASSN BD PHARMACY #
OH020035900OtherDANGEROUS DRUG DISTRI LIC