MEDICARE: LUXOTTICA OF AMERICA INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1104200658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUXOTTICA OF AMERICA INC.

Provider Business Mailing Address
First Line	:	4000 LUXOTTICA PL
Second Line	:	ATTN MEDICARE DEPT
City	:	MASON
State	:	OH
Zip	:	45040
Country	:	US
Telephone Number	:	513-765-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 N CAMPUS AVE
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91784-1667
Country	:	US
Telephone Number	:	909-285-3130
Fax Number	:

Authorized Official
Title or Position	:	CFO, NORTH AMERICA
Name	:	EMILIA FLAMINI
Credential	:
Telephone Number	:	513-765-6623

Provider Enumeration Date	:	07/15/2015
Last Update Date	:	04/06/2020

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