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LIFERX
NPI 1902140585
Family Medicine in Bloomington, IL

Active since November 20, 2012
2412 E WASHINGTON ST STE 6, BLOOMINGTON, IL 61704(309) 585-2116(309) 585-2152 Get Directions Write a Review

NPPES record last updated: September 21, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Liferx NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFERX (NPI 1902140585) is a healthcare organization registered as a family medicine in Bloomington, Illinois and active in the NPI registry since November 2012. The organization lists Clyde L Bass, President, as its authorized official.

NPPES Registry Identity

NPI1902140585
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFOUNTAIN HEALTHCARE LIMITED LIABILITY COMPANY
Location Address2412 E WASHINGTON ST STE 6Bloomington, IL 61704-4497
Mailing Address612 E Peru StPrinceton, IL 61356-1852 · (415) 754-3379
Phone(309) 585-2116
Fax(309) 585-2152
Organization SubpartNo
Authorized OfficialClyde L BassPresident · (415) 754-3379
Enumeration DateNovember 20, 2012
Last NPPES UpdateSeptember 21, 2016
✔ NPI 1902140585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2412 E WASHINGTON ST STE 6, Bloomington, IL 61704
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Other Names 1

Doing Business AsLiferx

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fountain Healthcare Limited Liability Company's NPI number?

The NPI number for Fountain Healthcare Limited Liability Company is 1902140585. It was assigned to this organization in the NPPES registry on November 20, 2012. The provider is doing business as Liferx.

Where is Fountain Healthcare Limited Liability Company located?

Fountain Healthcare Limited Liability Company is located at 2412 E Washington St Ste 6, Bloomington, IL 61704. The listed phone number is (309) 585-2116.

What is Fountain Healthcare Limited Liability Company's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Fountain Healthcare Limited Liability Company was last updated on September 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.