Organization
TRIVI DLP
Active
Other names
Trivillian's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PENIX PHARMD (OWNER)
(304) 546-9199
Entity
Organization
Contact information
Practice address
215 35TH ST SE, CHARLESTON, WV 25304-1318
(304) 343-8621
(304) 343-1015
Mailing address
215 35TH ST SE, CHARLESTON, WV 25304-1318
(304) 343-8621
(304) 343-1015
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552495
WV
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3910007195
—
WV
Enumeration date
07/23/2015
Last updated
04/09/2025
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