Healthcare Provider Details

I. General information

NPI: 1053448407
Provider Name (Legal Business Name): NKI ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/19/2025
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BLACKSTONE VALLEY PL
LINCOLN RI
02865-1185
US

IV. Provider business mailing address

11 BLACKSTONE VALLEY PL
LINCOLN RI
02865-1185
US

V. Phone/Fax

Practice location:
  • Phone: 401-726-6200
  • Fax: 401-351-5902
Mailing address:
  • Phone: 401-726-6200
  • Fax: 401-351-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHA00562
License Number StateRI
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ROBERT IACOBUCCI
Title or Position: PHAMACIST AND PRESIDENT
Credential: RPH
Phone: 401-726-6200