Healthcare Provider Details

I. General information

NPI: 1366439507
Provider Name (Legal Business Name): KCI USA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 S 900 W STE 88
SALT LAKE CITY UT
84104
US

IV. Provider business mailing address

6103 FARINON DR ATTN HCC
SAN ANTONIO TX
78249-3442
US

V. Phone/Fax

Practice location:
  • Phone: 801-972-1564
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ROSA GOMEZ
Title or Position: VP, MEDICARE ENROLLMENT
Credential:
Phone: 830-292-1612