Healthcare Provider Details

I. General information

NPI: 1467510305
Provider Name (Legal Business Name): LONDON REIBER PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3527 S FEDERAL WAY
BOISE ID
83705-5204
US

IV. Provider business mailing address

9820 DUNDEE CT
NAMPA ID
83686-3427
US

V. Phone/Fax

Practice location:
  • Phone: 208-424-7533
  • Fax: 208-424-7527
Mailing address:
  • Phone: 208-424-7533
  • Fax: 208-424-7527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberP5236
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: