Healthcare Provider Details

I. General information

NPI: 1174074140
Provider Name (Legal Business Name): LUXOTTICA OF AMERICA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WHITE OAKS MALL
SPRINGFIELD IL
62704-0501
US

IV. Provider business mailing address

4000 LUXOTTICA PL ATTN: MEDICARE DEPT
MASON OH
45040
US

V. Phone/Fax

Practice location:
  • Phone: 217-546-0738
  • Fax:
Mailing address:
  • Phone: 513-765-6623
  • 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, NORTH AMERICA
Credential:
Phone: 513-765-6623