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General NPI Number Information
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NPI Number | 1629261987
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Entity Type | Organization
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Legal Business Name | LUXOTTICA RETAIL NORTH AMERICA INC
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 510 N W LOOP 410 PARK NORTH S/C STE #105
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City | SAN ANTONIO
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State | TX
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Zip | 78216
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Country | US
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Telephone | 210-340-2993
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Fax | 210-340-7923
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Provider Business Mailing Address
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Address Line | 4000 LUXOTTICA PL ATTN MEDICARE DEPT
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City | MASON
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State | OH
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Zip | 45040-8114
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Country | US
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Telephone | 210-340-2993
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Fax | 210-340-7923
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Authorized Official
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Title or Position | MEDICARE SUPERVISOR
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Name | MS. WENDY UHLS
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Credential |
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Telephone | 513-765-3534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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