Park Nicollet Pharmacy #87017

LBN: Group Health Plan, Inc.
Park Nicollet Pharmacy #87017 is an health care organization with primary practice located at 3800 Park Nicollet Blvd Ste 1170 , St Louis Park MN 55416-2527. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Group Health Plan, Inc. can be contacted via phone (952) 977-3050, or through Busch, David via phone (952) 967-6876.

Contact Information

Primary practice address
3800 Park Nicollet Blvd Ste 1170 St Louis Park MN 55416-2527
Phone: (952) 977-3050
Fax: (952) 883-9747
Website:
Map and Directions
Authorized official contact:
Name: Busch, David
Phone: (952) 967-6876

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1104360973
LBN Legal business name Group Health Plan, Inc.
DBA Doing business as Park Nicollet Pharmacy #87017
Authorized official Busch, David
Entity Organization
Organization subpart 1 No
Enumeration date Dec 13th, 2016
Last updated Jun 8th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104360973 NPPES
Minnesota MEDICAID 155438300

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