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
—
—
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
Update your record
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