Organization
ALTAGRACE MEDICAL SUPPLIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACCIN JEAN-BAPTISTE (PRESIDENT)
(754) 779-7210
Entity
Organization
Contact information
Practice address
1915 NE 45TH ST STE 109, FORT LAUDERDALE, FL 33308-5118
(754) 779-7210
Mailing address
1915 NE 45TH ST STE 109, FORT LAUDERDALE, FL 33308-5118
(754) 779-7210
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/08/2020
Last updated
02/22/2021
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