Provider Demographics
NPI:1811957434
Name:RX INNOVATIONS, INC.
Entity type:Organization
Organization Name:RX INNOVATIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:505-881-4601
Mailing Address - Street 1:1128 HISTORIC ROUTE 66
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:NM
Mailing Address - Zip Code:88435-2712
Mailing Address - Country:US
Mailing Address - Phone:505-472-5666
Mailing Address - Fax:505-472-9666
Practice Address - Street 1:1128 HISTORIC ROUTE 66
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:NM
Practice Address - Zip Code:88435-2712
Practice Address - Country:US
Practice Address - Phone:505-472-5666
Practice Address - Fax:505-472-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM88484009332B00000X
NMPH00002614333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM3209497OtherNABP NUMBER
NMPH00002614OtherNM PHARMACY NUMBER
NMPH00002614OtherNM PHARMACY NUMBER