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General NPI Number Information
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NPI Number | 1487703336
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Entity Type | Organization
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Legal Business Name | UNION PACIFIC HEALTH SYSTEMS CLINIC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1400 DOUGLAS ST STOP 0030
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City | OMAHA
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State | NE
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Zip | 68179-1001
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Country | US
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Telephone | 402-544-3697
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Fax | 402-501-4085
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Provider Business Mailing Address
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Address Line | 1400 DOUGLAS ST STOP 0030
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City | OMAHA
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State | NE
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Zip | 68179-1001
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Country | US
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Telephone | 402-544-3697
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Fax | 402-501-4085
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Authorized Official
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Title or Position | CEO
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Name | MR. DELL T. BUTTERFIELD
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Credential |
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Telephone | 801-595-4363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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