Organization · Type 2 NPI

SCPG Louisiana LLC

Community/Retail Pharmacy · Lake Providence, LA

NPI number 1700436706 Active

Practice location

302 Lake St
Lake Providence, LA 71254-2630

Call (318) 559-2433 Map

Fax (318) 559-2437

Mailing address

PO Box 34407 Pmb 53760
Little Rock, AR 72203-4407

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

Another provider at this address

Brittany Nicole SheltonPharmacist Lake Providence, LA NPI 1750099578

Other community/retail pharmacy providers in Lake Providence

See all in Lake Providence →

NPI record

NPI: 1700436706
Entity type: Organization (Type 2)
Issued: Sep 12, 2019
Last updated: Nov 18, 2025
Status: Active

Other names

<unavail>
Express RX of Lake Providence · doing business as
Express RX of Lake Providence · doing business as

Authorized official

Mr. Umar Farooq
President
(501) 392-8680

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1700436706

SCPG Louisiana LLC's National Provider Identifier is 1700436706, issued on Sep 12, 2019. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Lake Providence, LA. The record was last updated on Nov 18, 2025.