Healthcare Provider Details
I. General information
NPI: 1558029553
Provider Name (Legal Business Name): LUXOTTICA OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/07/2021
Last Update Date: 12/07/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 CITADEL DR STE 567
COMMERCE CA
90040-1523
US
IV. Provider business mailing address
4000 LUXOTTICA PL ATTN MEDICARE DEPT
MASON OH
45040-8114
US
V. Phone/Fax
- Phone: 323-720-9291
- Fax:
- Phone: 513-765-6623
- 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