Provider Demographics
NPI:1710134416
Name:AETSERVE CORPORATION
Entity Type:Organization
Organization Name:AETSERVE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CRS
Authorized Official - Phone:561-687-4427
Mailing Address - Street 1:2111 BRANDYWINE RD
Mailing Address - Street 2:UNIT 4210
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7333
Mailing Address - Country:US
Mailing Address - Phone:561-687-4427
Mailing Address - Fax:561-683-1615
Practice Address - Street 1:2111 BRANDYWINE RD
Practice Address - Street 2:UNIT 4210
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-7333
Practice Address - Country:US
Practice Address - Phone:561-687-4427
Practice Address - Fax:561-683-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty