MEDICARE: SCPG ALABAMA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1811548746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCPG ALABAMA LLC

Provider Business Mailing Address
First Line	:	PO BOX 34407
Second Line	:	PMB 53760
City	:	LITTLE ROCK
State	:	AR
Zip	:	72203-4407
Country	:	US
Telephone Number	:	918-640-9270
Fax Number	:	205-921-1220

Provider Business Practice Location Address
First Line	:	1508 MILITARY ST S
Second Line	:
City	:	HAMILTON
State	:	AL
Zip	:	35570-5006
Country	:	US
Telephone Number	:	205-921-7465
Fax Number	:	205-921-7896

Authorized Official
Title or Position	:	PRESIDENT
Name	:	UMAR FAROOQ
Credential	:
Telephone Number	:	501-392-8680

Provider Enumeration Date	:	09/23/2019
Last Update Date	:	11/18/2025

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Directions to “SCPG ALABAMA LLC ” Practice Location

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