Organization
SCPG ARKANSAS LLC
Active
Organization
SCPG ARKANSAS LLC
Active
Other names
Express Rx of Pine Bluff
Organization subpart
No
Provider details
NPI number
Authorized official
UMAR FAROOQ (PRESIDENT)
(501) 392-8680
Entity
Organization
Contact information
Practice address
3006 WEST 28TH AVENUE, PINE BLUFF, AR 71603
(870) 850-0159
(870) 850-0177
Mailing address
PO BOX 34407 PMB 53760, LITTLE ROCK, AR 72203-4420
(501) 603-7409
(870) 245-1790
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20725
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198211407
—
AR
01
—
2141550
PK
—
Enumeration date
08/07/2013
Last updated
08/20/2026
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