Healthcare Provider Details

I. General information

NPI: 1396820361
Provider Name (Legal Business Name): LUXOTTICA OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date: 07/15/2013
Reactivation Date: 09/11/2013

III. Provider practice location address

2112 SHATTUCK AVE
BERKELEY CA
94704-1209
US

IV. Provider business mailing address

4000 LUXOTTICA PL ATTN: MEDICARE DEPT
MASON OH
45040-8114
US

V. Phone/Fax

Practice location:
  • Phone: 510-540-0556
  • Fax: 510-540-5542
Mailing address:
  • Phone: 513-765-2155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: SARA FRANCESCUTTO
Title or Position: CFO
Credential:
Phone: 513-765-2155