Organization
SCPG LOUISIANA LLC
Active
Other names
Express Rx of St. Joseph
Organization subpart
No
Provider details
NPI number
Authorized official
UMAR FAROOQ (PRESIDENT)
(501) 392-8680
Entity
Organization
Contact information
Practice address
705 PLANK RD, HIGHWAY 128, ST. JOSEPH, LA 71366
(318) 766-4563
(318) 766-4522
Mailing address
PO BOX 34407, PMB 53760, LITTLE ROCK, AR 72203-4407
(501) 534-4459
(501) 534-4460
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2207610
—
LA
Enumeration date
09/17/2019
Last updated
11/18/2025
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