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Contact Information

SCPG ARKANSAS LLC
3006 WEST 28TH AVENUE
PINE BLUFF, AR71603
 Phone: 870-850-0159
 Fax: 870-850-0177
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SCPG ARKANSAS LLC

NPI Number 1578995007
LBN Legal business name SCPG ARKANSAS LLC
Authorized official UMAR FAROOQ - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/07/2013
Last updated 11/18/2025 - About 7 months ago
Identifiers
AR License # AR20725
AR Medicaid 198211407
Other 2141550 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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