Provider Demographics
NPI:1871644138
Name:LUXOTTICA OF AMERICA INC.
Entity Type:Organization
Organization Name:LUXOTTICA OF AMERICA INC.
Other - Org Name:TARGET OPTICAL #1975
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:562-594-5546
Mailing Address - Fax:
Practice Address - Street 1:12300 SEAL BEACH BLVD
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2709
Practice Address - Country:US
Practice Address - Phone:562-594-5546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0180151814Medicare NSC