Provider Demographics
NPI:1669506762
Name:WESTERN KENTUCKY UNIVERSITY RESEARCH FOUNDATION, INC.
Entity Type:Organization
Organization Name:WESTERN KENTUCKY UNIVERSITY RESEARCH FOUNDATION, INC.
Other - Org Name:WESTERN KENTUCKY UNIVERSITY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:270-745-4652
Mailing Address - Street 1:1906 COLLEGE HEIGHTS BLVD # 11016
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1000
Mailing Address - Country:US
Mailing Address - Phone:270-745-4652
Mailing Address - Fax:270-745-4211
Practice Address - Street 1:1906 COLLEGE HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1000
Practice Address - Country:US
Practice Address - Phone:270-745-4125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)