# FOUNTAIN HOUSE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578642054
- **Authorized official:** MR. KENNETH ZIMMERMAN (PRESIDENT & CEO)
- **Authorized official phone:** (212) 582-0340

## Contact information

- **Practice address:** 425 W 47TH ST, NEW YORK, NY 10036-2304
- **Practice address phone:** (212) 582-0340
- **Practice address fax:** (212) 957-1424
- **Mailing address:** 425 W 47TH ST, NEW YORK, NY 10036-2304
- **Mailing address phone:** (212) 582-0340
- **Mailing address fax:** (212) 957-1424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 01303502 | NY | Yes |

## Other

- **Enumeration date:** 11/03/2006
- **Last updated:** 08/27/2024