Provider Demographics
NPI:1639040264
Name:SABINE OPTICAL LABORATORIES INC
Entity type:Organization
Organization Name:SABINE OPTICAL LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CARNAGGIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:225-295-4132
Mailing Address - Street 1:4615 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4465
Mailing Address - Country:US
Mailing Address - Phone:225-295-4132
Mailing Address - Fax:
Practice Address - Street 1:4615 S SHERWOOD FOREST BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4465
Practice Address - Country:US
Practice Address - Phone:225-295-4132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SABINE OPTICAL LABORATORIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2120425Medicaid
LA2583760Medicaid