MEDICARE: DUVALL ENTERPRISES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy
2	333600000X	Pharmacy	AR02329	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063410223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUVALL ENTERPRISES INC

Provider Business Mailing Address
First Line	:	P O BOX 240
Second Line	:
City	:	DARDANELLE
State	:	AR
Zip	:	72834-0240
Country	:	US
Telephone Number	:	479-229-4040
Fax Number	:	479-229-4049

Provider Business Practice Location Address
First Line	:	1176 STATE HIGHWAY 22 W STE A
Second Line	:
City	:	DARDANELLE
State	:	AR
Zip	:	72834-3006
Country	:	US
Telephone Number	:	479-229-4040
Fax Number	:	479-229-4049

Authorized Official
Title or Position	:	PRESIDENT/PHARMACIST
Name	:	MRS. MARSHA LEE PASCHAL DUVALL
Credential	:	PD
Telephone Number	:	479-229-4040

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	02/03/2021

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Directions to “DUVALL ENTERPRISES INC ” Practice Location

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