Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fountain Healthcare Limited Liability Company

Organization Family Medicine Physician · NPI 1902140585

Fountain Healthcare Limited Liability Company is a Family Medicine Physician in Bloomington, Illinois. Registered with an NPI since 2012.

In the registry since
2012

Practice location Address checks out

2412 E Washington St Ste 6
Bloomington, IL 61704-4497
Phone: (309) 585-2116
Fax: (309) 585-2152
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1902140585
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Clyde Bass — President · (415) 754-3379
Other names Liferx
NPI enumeratedNovember 20, 2012
Last updated in NPPESSeptember 21, 2016
Mailing address612 E Peru St, Princeton, IL 61356-1852

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