Provider Demographics
NPI:1487703336
Name:UNION PACIFIC HEALTH SYSTEMS CLINIC
Entity type:Organization
Organization Name:UNION PACIFIC HEALTH SYSTEMS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DELL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-595-4363
Mailing Address - Street 1:1400 DOUGLAS ST STOP 0030
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68179-1001
Mailing Address - Country:US
Mailing Address - Phone:402-544-3697
Mailing Address - Fax:402-501-4085
Practice Address - Street 1:1400 DOUGLAS ST STOP 0030
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68179-1001
Practice Address - Country:US
Practice Address - Phone:402-544-3697
Practice Address - Fax:402-501-4085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center