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General NPI Number Information
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NPI Number | 1215048913
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Entity Type | Organization
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Legal Business Name | GROUP HEALTH PLAN INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 9700 W 76TH ST STE B
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344
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Country | US
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Telephone | 952-829-3390
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Fax | 952-829-3380
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S MAILSTOP 21110Q
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City | MINNEAPOLIS
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State | MN
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Zip | 55440-1309
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Country | US
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Telephone | 952-883-7123
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Fax | 952-853-8727
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Authorized Official
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Title or Position | DIRECTOR
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Name | LISA BJORKMAN
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Credential |
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Telephone | 952-883-7469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 8600490
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License Number State | MN
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