Individual
DR. JERAMY RANDALL NEIBAUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
167 W MAIN ST STE 1, REXBURG, ID 83440-1826
(208) 356-4481
(208) 356-6915
Mailing address
167 W MAIN ST STE 1, REXBURG, ID 83440-1826
(208) 313-2816
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8033
ID
1835C0207X
Compounded Sterile Preparations Pharmacist
P8033
ID
1835P1200X
Pharmacotherapy Pharmacist
P8033
ID
Other
Enumeration date
06/19/2018
Last updated
03/10/2026
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