Organization
SCPG MISSISSIPPI LLC
Active
Other names
Express Rx of Vardaman
Organization subpart
No
Provider details
NPI number
Authorized official
UMAR FAROOQ (PRESIDENT)
(501) 392-8680
Entity
Organization
Contact information
Practice address
101 W SWEET POTATO ST, VARDAMAN, MS 38878-9433
(662) 682-7489
(662) 682-9132
Mailing address
PO BOX 7791, LITTLE ROCK, AR 72217-7791
(501) 258-4399
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/23/2019
Last updated
11/18/2025
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