Healthcare Provider Details
I. General information
NPI: 1275521569
Provider Name (Legal Business Name): KCI USA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2005
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
192 ATLANTIC ST
HACKENSACK NJ
07601
US
IV. Provider business mailing address
6103 FARINON DR ATTN HCC
SAN ANTONIO TX
78249-3442
US
V. Phone/Fax
- Phone: 201-343-4652
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 9004505 |
| Identifier Type | MEDICAID |
| Identifier State | NJ |
| Identifier Issuer | |
| # 2 | |
| Identifier | 02667307 |
| Identifier Type | MEDICAID |
| Identifier State | NY |
| Identifier Issuer | |
VIII. Authorized Official
Name:
ROSA
GOMEZ
Title or Position: VP, MEDICARE ENROLLMENT
Credential:
Phone: 830-292-1612