Healthcare Provider Details

I. General information

NPI: 1891536892
Provider Name (Legal Business Name): RXTEQ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 09/20/2025
Certification Date: 09/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S 2ND ST
RATON NM
87740-2102
US

IV. Provider business mailing address

8206 LOUISIANA BLVD NE
ALBUQUERQUE NM
87113-1738
US

V. Phone/Fax

Practice location:
  • Phone: 505-225-3020
  • Fax: 505-212-5265
Mailing address:
  • Phone: 505-225-3020
  • Fax: 505-212-5265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCIA HEFKER
Title or Position: OWNER / PROVIDER
Credential:
Phone: 505-225-3020