Provider Demographics
NPI:1265856868
Name:LUXOTTICA OF AMERICA INC.
Entity Type:Organization
Organization Name:LUXOTTICA OF AMERICA INC.
Other - Org Name:LENSCRAFTERS #02724
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, NORTH AMERICA
Authorized Official - Prefix:
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAMINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-765-6623
Mailing Address - Street 1:4000 LUXOTTICA PL ATTN MEDICARE DEPT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8114
Mailing Address - Country:US
Mailing Address - Phone:513-765-6623
Mailing Address - Fax:
Practice Address - Street 1:6170 GRAND AVE STE 807
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-4553
Practice Address - Country:US
Practice Address - Phone:847-856-8127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0180152690Medicare NSC