=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245388727
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUXOTTICA OF AMERICA INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 06/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 618 S ROUTE 59 STE 118
-----------------------------------------------------
City | NAPERVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60540-6100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-355-1134
-----------------------------------------------------
Fax | 630-355-1280
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4000 LUXOTTICA PL ATTN: MEDICARE DEPT
-----------------------------------------------------
City | MASON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45040-8114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-765-2155
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | SARA FRANCESCUTTO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 513-765-2155
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332H00000X
-----------------------------------------------------
Taxonomy Name | Eyewear Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------