Healthcare Provider Details

I. General information

NPI: 1083123236
Provider Name (Legal Business Name): PENN HIGHLANDS HOME MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2017
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 MAIN ST
BROOKVILLE PA
15825-0814
US

IV. Provider business mailing address

1376 CRESTVIEW RD
SAINT MARYS PA
15857-2200
US

V. Phone/Fax

Practice location:
  • Phone: 814-849-8278
  • Fax: 814-834-5383
Mailing address:
  • Phone: 814-834-2225
  • Fax: 814-834-5383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number3000009806
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1000002309
License Number StatePA

VIII. Authorized Official

Name: JOURDAN STRISHOCK
Title or Position: DELEGATED OFFICIAL
Credential:
Phone: 814-375-6160