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Organization

GROUP HEALTH PLAN, INC.

Active
Other names
Park Nicollet Pharmacy #87017
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID BUSCH (VP PHARMACY OPERATIONS)
(952) 967-6876
Entity
Organization

Contact information

Practice address
3800 PARK NICOLLET BLVD STE 1170, ST LOUIS PARK, MN 55416-2527
(952) 977-3050
(952) 883-9747
Mailing address
MSC 21111B PO BOX 1309, MINNEAPOLIS, MN 55440
(952) 967-6876
(952) 967-6667

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
155438300
MN
Enumeration date
12/13/2016
Last updated
06/08/2020
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