Provider Demographics
NPI:1215305412
Name:GROUP HEALTH PLAN INC
Entity type:Organization
Organization Name:GROUP HEALTH PLAN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BJORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-883-7469
Mailing Address - Street 1:8170 33RD AVE SOUTH
Mailing Address - Street 2:MAILSTOP 21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1309
Mailing Address - Country:US
Mailing Address - Phone:952-883-7670
Mailing Address - Fax:
Practice Address - Street 1:700 RIVARD ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:WI
Practice Address - Zip Code:54025
Practice Address - Country:US
Practice Address - Phone:715-247-2060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty