MEDICARE: PENN HOME 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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1942846605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENN HOME CARE LLC

Provider Business Mailing Address
First Line	:	2515 N FRONT ST
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17110-1150
Country	:	US
Telephone Number	:	717-857-4371
Fax Number	:	717-210-5738

Provider Business Practice Location Address
First Line	:	2515 N FRONT ST
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17110-1150
Country	:	US
Telephone Number	:	717-592-0971
Fax Number	:

Authorized Official
Title or Position	:	ALT ADMIN
Name	:	NOUR MAKHOUL
Credential	:
Telephone Number	:	717-857-4371

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	06/06/2026

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Directions to “PENN HOME CARE LLC ” Practice Location

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