MEDICARE: PENNIE'S R US HOME HEALTH CARE AGENCY CORPORATION

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	:	1689443186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENNIE'S R US HOME HEALTH CARE AGENCY CORPORATION

Provider Business Mailing Address
First Line	:	6301 NW 5TH WAY STE 3500
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6131
Country	:	US
Telephone Number	:	954-900-6693
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 NW 5TH WAY STE 3500
Second Line	:	STE 316
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6131
Country	:	US
Telephone Number	:	954-900-6693
Fax Number	:	954-900-9639

Authorized Official
Title or Position	:	CEO
Name	:	AKELIA M RANKINE
Credential	:
Telephone Number	:	770-865-1233

Provider Enumeration Date	:	12/26/2023
Last Update Date	:	03/12/2025

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