Organization
KALEIDOSCOPE ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONAVON MORGAN SR. (PRESIDENT)
(806) 359-4550
Entity
Organization
Contact information
Practice address
6817 WOLFLIN AVE, SUITE 3, AMARILLO, TX 79106-2174
(806) 367-5047
Mailing address
PO BOX 52108, AMARILLO, TX 79159-2108
(806) 367-5047
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182848501
—
TX
05
—
182848502
—
TX
01
—
532278
BCBS
TX
Enumeration date
08/04/2006
Last updated
01/18/2012
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