Healthcare Provider Details

I. General information

NPI: 1780516963
Provider Name (Legal Business Name): ALTRA TECH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 NORTHAVEN AVE
SUWANEE GA
30024-5035
US

IV. Provider business mailing address

3235 SATELLITE BLVD STE 300
DULUTH GA
30096-8688
US

V. Phone/Fax

Practice location:
  • Phone: 346-410-8852
  • Fax: 800-507-1673
Mailing address:
  • Phone: 346-410-8852
  • Fax: 800-507-1673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CHANG SEOL LEE
Title or Position: OWNER
Credential:
Phone: 346-410-8852