Healthcare Provider Details

I. General information

NPI: 1104514470
Provider Name (Legal Business Name): LUXOTTICA OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11133 BALBOA BLVD
GRANADA HILLS CA
91344-4204
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 818-360-2999
  • Fax:
Mailing address:
  • Phone: 513-765-2155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

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