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
11/18/2025
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