Altagrace Medical Supplies Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ALTAGRACE MEDICAL SUPPLIES INC

Practice address

1915 NE 45TH St Ste 109
Fort Lauderdale, FL 33308-5118

Phone

(754) 779-7210

NPI assigned

May 8, 2020

Last updated

Feb 22, 2021By 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

Jaccin Jean-Baptiste

Title

President

Phone

(754) 779-7210

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1699397075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 NE 45TH ST STE 109",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085118",
            "telephone_number": "754-779-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 NE 45TH ST STE 109",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085118",
            "telephone_number": "754-779-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAGRACE MEDICAL SUPPLIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-08",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "JEAN-BAPTISTE",
        "authorized_official_first_name": "JACCIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "754-779-7210"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "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 Feb 22, 2021; 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.