Fountain Healthcare Limited Liability Company
Fountain Healthcare Limited Liability Company provides Family Medicine Physician services in Bloomington, Illinois. Registered with an NPI since 2012.
- In the registry since
- 2012
Practice location Address checks out
2412 E Washington St Ste 6Bloomington, IL 61704-4497 Not confirmed with CMS for 10 years — call before visiting
Phone: (309) 585-2116
Fax: (309) 585-2152
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X |
|---|
Record details
| NPI number | 1902140585 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Clyde Bass — President · (415) 754-3379 |
| Other names | Liferx |
| NPI enumerated | November 20, 2012 |
| Last updated in NPPES | September 21, 2016 |
| Mailing address | 612 E Peru St, Princeton, IL 61356-1852 |
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