Healthcare Provider Details

I. General information

NPI: 1528995131
Provider Name (Legal Business Name): PENSYLVA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W 7TH ST STE 100
ERIE PA
16502-1333
US

IV. Provider business mailing address

502 W 7TH ST STE 100
ERIE PA
16502-1333
US

V. Phone/Fax

Practice location:
  • Phone: 207-453-9235
  • Fax:
Mailing address:
  • Phone: 207-453-9235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM SKLEDAR
Title or Position: MANAGER
Credential:
Phone: 207-453-9235