MEDICARE: PENN HIGHLANDS HOME MEDICAL EQUIPMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336S0011X	Specialty Pharmacy
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	PP481849	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2116840	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306094206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENN HIGHLANDS HOME MEDICAL EQUIPMENT LLC

Provider Business Mailing Address
First Line	:	4 RAILROAD ST
Second Line	:
City	:	SAINT MARYS
State	:	PA
Zip	:	15857-1729
Country	:	US
Telephone Number	:	814-834-3017
Fax Number	:	814-834-6510

Provider Business Practice Location Address
First Line	:	190 N FRALEY ST
Second Line	:	SUITE 2
City	:	KANE
State	:	PA
Zip	:	16735-1165
Country	:	US
Telephone Number	:	814-837-8500
Fax Number	:	814-837-8501

Authorized Official
Title or Position	:	DIRECTOR RETAIL PHARMACY OPERATIONS
Name	:	MICHELLE M BENNETT
Credential	:
Telephone Number	:	814-299-7553

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/22/2025

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Directions to “PENN HIGHLANDS HOME MEDICAL EQUIPMENT LLC ” Practice Location

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