Provider Demographics
NPI:1659422970
Name:LUXOTTICA OF AMERICA INC.
Entity Type:Organization
Organization Name:LUXOTTICA OF AMERICA INC.
Other - Org Name:TARGET OPTICAL #C4157
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
Mailing Address - Street 2:ATTN MEDICARE DEPT
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8114
Mailing Address - Country:US
Mailing Address - Phone:262-207-0023
Mailing Address - Fax:
Practice Address - Street 1:4798 S MOORLAND RD
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-7486
Practice Address - Country:US
Practice Address - Phone:262-207-0023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0180152172Medicare NSC