Aetserve Corporation

Primary specialty

ContractorTaxonomy code 171W00000X

Legal business name

AETSERVE CORPORATION

Practice address

2111 Brandywine Rd
Unit 4210
West Palm Beach, FL 33409-7333

Phone

(561) 687-4427

Fax

(561) 683-1615

NPI assigned

Aug 25, 2008

Last updated

Aug 25, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Edward M. Tucker, B.A., C.R.S.

Title

President

Phone

(561) 687-4427

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1710134416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 BRANDYWINE RD",
            "address_2": "UNIT 4210",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334097333",
            "telephone_number": "561-687-4427",
            "fax_number": "561-683-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 BRANDYWINE RD",
            "address_2": "UNIT 4210",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334097333",
            "telephone_number": "561-687-4427",
            "fax_number": "561-683-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AETSERVE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-25",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-687-4427",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.A., C.R.S."
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.