Provider Demographics
NPI:1124109897
Name:SAINT OPTICAL
Entity type:Organization
Organization Name:SAINT OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MILLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-652-4097
Mailing Address - Street 1:916 CARROLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3304
Mailing Address - Country:US
Mailing Address - Phone:985-652-4097
Mailing Address - Fax:985-652-9917
Practice Address - Street 1:916 CARROLLWOOD DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3304
Practice Address - Country:US
Practice Address - Phone:985-652-4097
Practice Address - Fax:985-652-9917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1365114Medicaid
LA1365114Medicaid