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San-San Cooley

Optometrist

Eye and Vision Services Providers

PECOS Enrollment

Based on the most recent information from CMS, provider San-San Cooley is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1033340468
Provider Type
Individual
Full Name
Cooley, San-San
Title
Dr.
Credential
O.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
8/3/2009
Last Updated
12/3/2024

Contact Information

Practice Location

265 N Liberty St, Powell, OH 43065-8870

(614) 793-0700

Unlisted Fax

Mailing Location

265 N Liberty St, Powell, OH 43065-8870

(614) 793-0700

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 152W00000X Primary	Description Optometrist Eye and Vision Services Providers	License 5854 Ohio

San-San Cooley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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