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Organization
SCPG MISSISSIPPI LLC
Active
Organization
SCPG MISSISSIPPI LLC
Active
Other names
CRANFORDS DRUG STORE, Express Rx of Seminary
Organization subpart
No
Provider details
NPI number
Authorized official
UMAR FAROOQ (PRESIDENT)
(501) 392-8680
Entity
Organization
Contact information
Practice address
121 W. MAIN ST, SEMINARY, MS 39479
(601) 722-3291
(601) 722-3264
Mailing address
PO BOX 34407 PMP 53760, LITTLE ROCK, AR 72203-4420
(501) 534-4459
(501) 534-4460
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
00729
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00031143
—
MS
01
—
2050516
PK
—
Enumeration date
08/14/2006
Last updated
11/18/2025
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