Healthcare Provider Details

I. General information

NPI: 1871239731
Provider Name (Legal Business Name): LUXOTTICA OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/12/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVY EXCHANGE RD BLDG 258
SANTA RITA GU
96915
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 671-564-9993
  • 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: EMILIA FLAMINI
Title or Position: CFO
Credential:
Phone: 513-765-6623