# SOUTH EAST AMBULANCE DISTRICT

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

## Provider details

- **NPI number:** 1629535133
- **Authorized official:** JERRY L HOUTZ JR. (DISTRICT BOARD CHAIRMAN)
- **Authorized official phone:** (419) 575-4833

## Contact information

- **Practice address:** 1968 MERMILL RD, BRADNER, OH 43406-9766
- **Practice address phone:** (419) 800-8033
- **Practice address fax:** (419) 800-8117
- **Mailing address:** 1968 MERMILL RD, BRADNER, OH 43406-9766

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 02/21/2019
- **Last updated:** 04/19/2022