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NPI Code Detail

MEDICARE: LUXOTTICA RETAIL NORTH AMERICA INC

MEDICARE: LUXOTTICA RETAIL NORTH AMERICA INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1568680510
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUXOTTICA RETAIL NORTH AMERICA INC
Provider Business Mailing Address
First Line : 4000 LUXOTTICA PL
Second Line : ATTN MEDICARE DEPT
City : MASON
State : OH
Zip : 45040-8114
Country : US
Telephone Number : 904-223-0808
Fax Number :
Provider Business Practice Location Address
First Line : 13740 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-6033
Country : US
Telephone Number : 904-223-0808
Fax Number :
Authorized Official
Title or Position : SPECIALIST
Name : MR. TERRY KROTH
Credential :
Telephone Number : 513-765-3060
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/19/2013

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Directions to “LUXOTTICA RETAIL NORTH AMERICA INC ” Practice Location

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