Provider Demographics
NPI:1467646273
Name:ZOEY K. LOOMIS, O.D., P.C.
Entity Type:Organization
Organization Name:ZOEY K. LOOMIS, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZOEY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:LOOMIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-867-3937
Mailing Address - Street 1:529 SAUNDERS ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701
Mailing Address - Country:US
Mailing Address - Phone:970-867-3937
Mailing Address - Fax:970-867-3037
Practice Address - Street 1:529 SAUNDERS ROAD
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701
Practice Address - Country:US
Practice Address - Phone:970-867-3937
Practice Address - Fax:970-867-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT 1825152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DO2221OtherRAILROAD MEDICARE
CO64656276Medicaid
DO2221OtherRAILROAD MEDICARE
COU62990Medicare UPIN
COC809648Medicare PIN