MEDICARE: VALET TRASH PICKUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171WH0202X	Home Modifications Contractor

General Provider Information

NPI Number	:	1407623804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALET TRASH PICKUP

Provider Business Mailing Address
First Line	:	4510 14TH AVE
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-3921
Country	:	US
Telephone Number	:	319-259-2875
Fax Number	:

Provider Business Practice Location Address
First Line	:	4510 14TH AVE
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-3921
Country	:	US
Telephone Number	:	319-259-2875
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. CALEB CRAWFORD
Credential	:
Telephone Number	:	319-259-2875

Provider Enumeration Date	:	12/06/2023
Last Update Date	:	12/06/2023

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Directions to “VALET TRASH PICKUP ” Practice Location

Language	Start Address	Practice Location

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