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General NPI Number Information
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NPI Number | 1316955065
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Entity Type | Organization
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Legal Business Name | KALEIDOSCOPE ENTERPRISES LLC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 6817 WOLFLIN AVE SUITE 3
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City | AMARILLO
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State | TX
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Zip | 79106-2174
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Country | US
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Telephone | 806-367-5047
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 52108
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City | AMARILLO
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State | TX
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Zip | 79159-2108
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Country | US
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Telephone | 806-367-5047
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DONAVON MORGAN SR.
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Credential |
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Telephone | 806-359-4550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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