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General NPI Number Information
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NPI Number | 1871534628
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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 | 06/10/2006
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 8170 33RD AVENUE SOUTH MAILSTOP 22201H
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1575
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Country | US
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Telephone | 952-883-6877
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Fax | 952-883-6883
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Provider Business Mailing Address
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Address Line | 8170 33RD AVENUE SOUTH MAILSTOP 22201H
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City | BLOOMINGTON
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State | MN
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Zip | 55425-4516
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Country | US
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Telephone | 952-883-6877
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Fax |
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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 | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 8600490
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License Number State | MN
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