# ALTAGRACE MEDICAL SUPPLIES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699397075
- **Authorized official:** JACCIN JEAN-BAPTISTE (PRESIDENT)
- **Authorized official phone:** (754) 779-7210

## Contact information

- **Practice address:** 1915 NE 45TH ST STE 109, FORT LAUDERDALE, FL 33308-5118
- **Practice address phone:** (754) 779-7210
- **Mailing address:** 1915 NE 45TH ST STE 109, FORT LAUDERDALE, FL 33308-5118
- **Mailing address phone:** (754) 779-7210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 05/08/2020
- **Last updated:** 02/22/2021