Healthcare Provider Details
I. General information
NPI: 1053083741
Provider Name (Legal Business Name): LUXOTTICA OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2021
Last Update Date: 09/30/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1065 BREA MALL # 2021
BREA CA
92821-5718
US
IV. Provider business mailing address
4000 LUXOTTICA PL ATTN MEDICARE DEPT
MASON OH
45040-8114
US
V. Phone/Fax
- Phone: 714-990-5947
- Fax:
- Phone: 513-765-6000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMILIA
FLAMINI
Title or Position: CFO, NORTH AMERICA
Credential:
Phone: 513-765-6623