Luxottica Retail North America Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

LUXOTTICA RETAIL NORTH AMERICA INC

Doing business as

PEARLE VISION #6315

Practice address

1600 N Sr 50
Northfield Square
Bourbonnais, IL 60914-9307

Phone

(815) 935-0404

NPI assigned

Oct 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Terry Kroth

Title

Specialist

Phone

(513) 765-3060

Specialties & licenses 1

Addresses

Other names 1

• PEARLE VISION #6315 Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1710074943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 LUXOTTICA PL",
            "address_2": "ATTN MEDICARE DEPT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408114",
            "telephone_number": "815-935-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N SR 50",
            "address_2": "NORTHFIELD SQUARE",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609149307",
            "telephone_number": "815-935-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXOTTICA RETAIL NORTH AMERICA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "KROTH",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "SPECIALIST",
        "authorized_official_telephone_number": "513-765-3060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARLE VISION #6315",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Eyewear Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.