Healthcare Provider Details

I. General information

NPI: 1194371872
Provider Name (Legal Business Name): ADAM J GLOVER PHARM, D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2019
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5230 W FRANKLIN RD
BOISE ID
83705-1109
US

IV. Provider business mailing address

5230 W FRANKLIN RD
BOISE ID
83705-1109
US

V. Phone/Fax

Practice location:
  • Phone: 208-428-6433
  • Fax: 208-429-6427
Mailing address:
  • Phone: 208-429-6433
  • Fax: 208-429-6427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPNT.048040
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberP9173
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHRM.PH.61592095
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHA.0023337
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: