Organization
NEUTRON LAB LLC
Active
Other names
Lavon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAMME FERREIRO PHARM D (MANAGING OFFICER)
(972) 843-7010
Entity
Organization
Contact information
Practice address
440 STATE HIGHWAY 78 STE 230, LAVON, TX 75166-1266
(972) 843-7010
(972) 200-3017
Mailing address
440 STATE HIGHWAY 78 STE 230, LAVON, TX 75166-1266
(972) 843-7010
(972) 200-3017
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
29073
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149899
—
TX
Enumeration date
06/30/2014
Last updated
11/05/2021
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