Provider Demographics
NPI:1306233069
Name:MOURNING, FRANCIS RICHARD (RPH)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:RICHARD
Last Name:MOURNING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8498 206TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MN
Mailing Address - Zip Code:56273-9741
Mailing Address - Country:US
Mailing Address - Phone:320-212-2482
Mailing Address - Fax:
Practice Address - Street 1:216 WASHBURNE AVE
Practice Address - Street 2:
Practice Address - City:PAYNESVILLE
Practice Address - State:MN
Practice Address - Zip Code:56362-1643
Practice Address - Country:US
Practice Address - Phone:320-243-3781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN112692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist