Healthcare Provider Details

I. General information

NPI: 1437063872
Provider Name (Legal Business Name): ABIGAIL GRACE MARSHALL PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 SE 14TH ST
BENTONVILLE AR
72712-4931
US

IV. Provider business mailing address

3510 SE 14TH ST
BENTONVILLE AR
72712-4931
US

V. Phone/Fax

Practice location:
  • Phone: 479-621-6470
  • Fax:
Mailing address:
  • Phone: 479-621-6470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD17867
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: