Basic Information
| Provider Information | |||||||||
| NPI: | 1235381450 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LUXOTTICA OF AMERICA INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LENSCRAFTERS #5782 | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 LUXOTTICA PL | ||||||||
| Address2: | ATTN MEDICARE DEPT | ||||||||
| City: | MASON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450408114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586731084 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11134 RANCHO CARMEL DR | ||||||||
| Address2: | STE #102 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921284671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586731084 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2008 | ||||||||
| LastUpdateDate: | 03/02/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | FLAMINI | ||||||||
| AuthorizedOfficialFirstName: | EMILIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO, NORTH AMERICA | ||||||||
| AuthorizedOfficialTelephone: | 5137656623 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
No ID Information.