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NPI Code Detail

MEDICARE: GROUP HEALTH PLAN INC

MEDICARE: GROUP HEALTH PLAN INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1043365208
Entity Type Code : Organization
Provider Name (Legal Business Name) : GROUP HEALTH PLAN INC
Provider Business Mailing Address
First Line : 8100 34TH AVE S
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-1672
Country : US
Telephone Number : 952-883-5151
Fax Number : 952-883-5160
Provider Business Practice Location Address
First Line : 2165 WHITE BEAR AVE N
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-2707
Country : US
Telephone Number : 651-770-8828
Fax Number : 651-779-1570
Authorized Official
Title or Position : CAO
Name : KATHLEEN M COONEY
Credential :
Telephone Number : 952-883-7565
Provider Enumeration Date : 01/25/2007
Last Update Date : 08/22/2020

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Directions to “GROUP HEALTH PLAN INC ” Practice Location

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