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NPI Code Detail

MEDICARE: LUXOTTICA RETAIL NORTH AMERICA INC

MEDICARE: LUXOTTICA RETAIL NORTH 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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1982701983
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUXOTTICA RETAIL NORTH 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 : 541-440-3816
Fax Number :
Provider Business Practice Location Address
First Line : 1400 NW GARDEN VLY
Second Line : ROSEBURG VALLEY MALL
City : ROSEBURG
State : OR
Zip : 97470-1766
Country : US
Telephone Number : 541-440-3816
Fax Number :
Authorized Official
Title or Position : MEDICARE ADMINISTRATOR
Name : MS. WENDY UHLS
Credential :
Telephone Number : 513-765-3534
Provider Enumeration Date : 09/20/2006
Last Update Date : 01/06/2010

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Directions to “LUXOTTICA RETAIL NORTH AMERICA INC ” Practice Location

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