Organization
NW OTTER CREEK LLC
Active
Other names
Express Rx at Otter Creek
Organization subpart
No
Provider details
NPI number
Authorized official
UMAR FAROOQ (PRESIDENT)
(501) 392-8680
Entity
Organization
Contact information
Practice address
10100 STAGECOACH RD, LITTLE ROCK, AR 72210-5742
(501) 455-2522
Mailing address
PO BOX 7791, LITTLE ROCK, AR 72217-7791
(855) 553-9777
(501) 246-3842
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221379407
—
AR
Enumeration date
04/04/2017
Last updated
11/18/2025
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