Provider Demographics
NPI:1891536892
Name:RXTEQ LLC
Entity type:Organization
Organization Name:RXTEQ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEFKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-205-8822
Mailing Address - Street 1:8206 LOUISIANA BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1738
Mailing Address - Country:US
Mailing Address - Phone:575-205-8822
Mailing Address - Fax:833-972-5243
Practice Address - Street 1:1400 S 2ND ST
Practice Address - Street 2:
Practice Address - City:RATON
Practice Address - State:NM
Practice Address - Zip Code:87740-2102
Practice Address - Country:US
Practice Address - Phone:575-205-8822
Practice Address - Fax:833-972-5243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty