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	:	1619031275
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	:	45040-8114
Country	:	US
Telephone Number	:	360-357-2542
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 BLACK LAKE BLVD SW STE 110
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-8603
Country	:	US
Telephone Number	:	360-357-2542
Fax Number	:

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	06/06/2019

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