Healthcare Provider Details

I. General information

NPI: 1811957434
Provider Name (Legal Business Name): RX INNOVATIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 HISTORIC ROUTE 66
SANTA ROSA NM
88435-2712
US

IV. Provider business mailing address

1128 HISTORIC ROUTE 66
SANTA ROSA NM
88435-2712
US

V. Phone/Fax

Practice location:
  • Phone: 505-472-5666
  • Fax: 505-472-9666
Mailing address:
  • Phone: 505-472-5666
  • Fax: 505-472-9666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH00002614
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number88484009
License Number StateNM

VIII. Authorized Official

Name: MR. JEFFREY PETER CAMPBELL
Title or Position: PRESIDENT
Credential: RPH
Phone: 505-881-4601