MEDICARE: PENN MEDICAL HOME HEALTH CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1538818679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENN MEDICAL HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	108 N MOUNTAIN RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-2616
Country	:	US
Telephone Number	:	717-678-1320
Fax Number	:	717-678-6030

Provider Business Practice Location Address
First Line	:	108 N MOUNTAIN RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-2616
Country	:	US
Telephone Number	:	717-678-1320
Fax Number	:	717-678-6030

Authorized Official
Title or Position	:	ALT ADMIN
Name	:	NOOR MAKHOUL
Credential	:
Telephone Number	:	717-678-1320

Provider Enumeration Date	:	03/23/2022
Last Update Date	:	06/06/2026

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