Provider Demographics
NPI:1568756153
Name:MURAD, MONA (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:MONA
Middle Name:
Last Name:MURAD
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 MAINE AVENUE SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904
Mailing Address - Country:US
Mailing Address - Phone:507-206-5021
Mailing Address - Fax:507-206-5031
Practice Address - Street 1:4611 MAINE AVE SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6929
Practice Address - Country:US
Practice Address - Phone:507-206-5021
Practice Address - Fax:507-206-5031
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119196183500000X
FLPS37368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist