Healthcare Provider Details

I. General information

NPI: 1700575560
Provider Name (Legal Business Name): LUXOTTICA OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 CAMINO DE LA PLZ STE 134
SAN DIEGO CA
92173-3048
US

IV. Provider business mailing address

4000 LUXOTTICA PLACE ATTN MEDICARE DEPT.
MASON OH
45040-8114
US

V. Phone/Fax

Practice location:
  • Phone: 619-690-5707
  • Fax:
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