Healthcare Provider Details

I. General information

NPI: 1104740562
Provider Name (Legal Business Name): ABIGAIL GRACE GREVEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E SHERMAN BLVD
MUSKEGON MI
49444-1849
US

IV. Provider business mailing address

578 S BEAR LAKE RD
NORTH MUSKEGON MI
49445-2373
US

V. Phone/Fax

Practice location:
  • Phone: 231-672-2000
  • Fax:
Mailing address:
  • Phone: 231-672-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419171
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: