Provider Demographics
NPI:1699343160
Name:KOIKI, OLADIPO
Entity type:Individual
Prefix:
First Name:OLADIPO
Middle Name:
Last Name:KOIKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 BELVEDERE DR
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-3603
Mailing Address - Country:US
Mailing Address - Phone:347-409-1512
Mailing Address - Fax:
Practice Address - Street 1:2100 HIGHLAND CORPORATE DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-8703
Practice Address - Country:US
Practice Address - Phone:888-694-7287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist