Healthcare Provider Details

I. General information

NPI: 1831435452
Provider Name (Legal Business Name): SCPG ARKANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2012
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 SAWTOOTH OAK STREET
HOT SPRINGS AR
71901
US

IV. Provider business mailing address

PO BOX 34407 PMB 53760
LITTLE ROCK AR
72203-4420
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-2222
  • Fax: 870-245-1790
Mailing address:
  • Phone: 501-603-7409
  • Fax: 501-321-1201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: UMAR FAROOQ
Title or Position: PRESIDENT
Credential:
Phone: 501-392-8680