MEDICARE: WERNER ENTERPRISES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility	327585	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881681997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WERNER ENTERPRISES INC.

Provider Business Mailing Address
First Line	:	3427 CENTRAL AVE NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-1221
Country	:	US
Telephone Number	:	612-788-9757
Fax Number	:	612-789-6564

Provider Business Practice Location Address
First Line	:	3427 CENTRAL AVE NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-1221
Country	:	US
Telephone Number	:	612-788-9757
Fax Number	:	612-789-6564

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. RICHARD CLEM WERNER
Credential	:
Telephone Number	:	612-788-9757

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	08/22/2020

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