| Name: | NKI Enterprises, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 07 Jan 1993 (32 years ago) |
| Identification Number: | 000070868 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 1057 MINERAL SPRING AVENUE, NORTH PROVIDENCE, RI, 02904, USA |
| Purpose: | SALES OF GENERAL PRODUCTS AND PHARMACEUTICAL PRODUCTS. |
| NAICS: | 446110 - Pharmacies and Drug Stores |
| Fictitious names: |
WHITE CROSS PHARMACY Professional Services (trading name, 1997-02-26 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053448407 | 2007-02-27 | 2024-04-12 | 11 BLACKSTONE VALLEY PL, LINCOLN, RI, 028651185, US | 11 BLACKSTONE VALLEY PL, LINCOLN, RI, 028651185, US | |||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 401-726-6200 |
| Fax | 4013515902 |
Authorized person
| Name | ROBERT IACOBUCCI |
| Role | PHAMACIST AND PRESIDENT |
| Phone | 4017266200 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PHA00562 |
| State | RI |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9010278 |
| State | RI |
| Issuer | PK |
| Number | 2089241 |
| Name | Role | Address |
|---|---|---|
| BETH I. BROWN | Agent | 1057 MINERAL SPRING AVENUE, NORTH PROVIDENCE, RI, 02904, USA |
| Name | Role | Address |
|---|---|---|
| ROBERT LOUIS IACOBUCCI | PRESIDENT | 54 CARRIAGE DRIVE LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| BETH IACOBUCCI BROWN | TREASURER | 12 LORD FOX RUN LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| NANCY KELLY IACOBUCCI | SECRETARY | 54 CARRIAGE DR LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| ROBERT JORDAN IACOBUCCI | VICE PRESIDENT | 2 HENRY DRIVE LINCOLN, RI 02865 USA |
| Number | Name | File Date |
|---|---|---|
| 202446402530 | Annual Report | 2024-02-14 |
| 202328595750 | Annual Report - Amended | 2023-02-17 |
| 202328493740 | Annual Report | 2023-02-17 |
| 202213333450 | Annual Report | 2022-03-23 |
| 202191336630 | Annual Report | 2021-02-15 |
| 202032435890 | Annual Report | 2020-01-15 |
| 201984573940 | Annual Report | 2019-01-16 |
| 201858737500 | Annual Report | 2018-02-21 |
| 201734514030 | Annual Report | 2017-02-22 |
| 201690141990 | Annual Report | 2016-01-06 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
