Healthcare Provider Details

I. General information

NPI: 1619811908
Provider Name (Legal Business Name): GROUP HEALTH PLAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 UTICA AVENUE SOUTH SUITE 100
SAINT LOUIS PARK MN
55416
US

IV. Provider business mailing address

8170 33RD AVENUE SOUTH MAILSTOP 21110Q
BLOOMINGTON MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 952-541-2578
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: LISA BJORKMAN
Title or Position: DIRECTOR
Credential:
Phone: 952-883-7469