Provider Demographics
NPI:1194712331
Name:KCI USA, INC.
Entity type:Organization
Organization Name:KCI USA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CCO, VP, COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRAEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-255-6092
Mailing Address - Street 1:6103 FARINON DR
Mailing Address - Street 2:ATTN HCC
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1155 E NORTH AVE
Practice Address - Street 2:STE 105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93725
Practice Address - Country:US
Practice Address - Phone:559-457-0838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KCI USA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-03
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME02929FMedicaid
CADME02929FMedicaid