Provider Demographics
NPI:1689068462
Name:GROUP HEALTH PLAN, INC.
Entity Type:Organization
Organization Name:GROUP HEALTH PLAN, INC.
Other - Org Name:HEALTHPARTNERS RIVERWAY PAIN CLINIC
Other - Org Type:Doing Business As
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:952-883-7469
Mailing Address - Fax:952-883-5395
Practice Address - Street 1:2621 GREENHAVEN RD
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-5566
Practice Address - Country:US
Practice Address - Phone:763-587-4488
Practice Address - Fax:763-587-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain