# SCPG MISSISSIPPI LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CRANFORDS DRUG STORE, Express Rx of Seminary
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205849221
- **Authorized official:** UMAR FAROOQ (PRESIDENT)
- **Authorized official phone:** (501) 392-8680

## Contact information

- **Practice address:** 121 W. MAIN ST, SEMINARY, MS 39479
- **Practice address phone:** (601) 722-3291
- **Practice address fax:** (601) 722-3264
- **Mailing address:** PO BOX 34407 PMP 53760, LITTLE ROCK, AR 72203-4420
- **Mailing address phone:** (501) 534-4459
- **Mailing address fax:** (501) 534-4460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 00729 | MS | Yes |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 11/18/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00031143 | — | MS |
| 01 | — | 2050516 | PK | — |