SCPG Louisiana LLC

Organization Active NPI Community/Retail Pharmacy · Lake Providence, LA

NPI 1700436706 · NPPES record last updated Nov 18, 2025

Key facts

NPI
1700436706
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
SCPG LOUISIANA LLC
Practice address
302 Lake St
Lake Providence, LA 71254-2630
Phone
(318) 559-2433
Fax
(318) 559-2437
NPI assigned
Sep 12, 2019
Organization subpart
No

Authorized official

Name
Mr. Umar Farooq
Title
President
Phone
(501) 392-8680

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

302 Lake St
Lake Providence, LA 71254
Phone (318) 559-2433

303 N Hood St
#1
Lake Providence, LA 71254

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

302 Lake St
Lake Providence, LA 71254-2630

Mailing address

PO Box 34407 PMB 53760
Little Rock, AR 72203-4407
Phone (501) 534-4459

Other names

  • Express Rx of Lake Providence Doing business as

Other providers in Lake Providence, LA

All providers in Lake Providence, LA · Community/Retail Pharmacy in Louisiana

Sources for this page

Verify at the official NPI Registry.