Provider Demographics
NPI:1831182799
Name:ZION EYE INSTITUTE, INC
Entity type:Organization
Organization Name:ZION EYE INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-656-2020
Mailing Address - Street 1:1791 E 280 N
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2463
Mailing Address - Country:US
Mailing Address - Phone:435-656-2020
Mailing Address - Fax:435-673-4131
Practice Address - Street 1:1791 E 280 N
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2463
Practice Address - Country:US
Practice Address - Phone:435-656-2020
Practice Address - Fax:435-673-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3020261QS0132X
261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6880028OtherUHC NUMBER
UT186489OtherIHC NUMBER
NV004685004Medicaid
UT490003686OtherRAILROAD MEDICARE
UT490003686OtherRAILROAD MEDICARE
UT186489OtherIHC NUMBER
UT=========003Medicaid