Basic Information
Provider Information
NPI: 1386699825
EntityType: 2
ReplacementNPI:  
OrganizationName: FIVE CS COMMUNICATION CARE PLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: SONUS SF0002
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 5000 CHESHIRE PKWY N
Address2:  
City: PLYMOUTH
State: MN
PostalCode: 554464103
CountryCode: US
TelephoneNumber: 8885100766
FaxNumber: 7632684017
Practice Location
Address1: 102 S 3RD ST
Address2: STE 300
City: CARSON CITY
State: MI
PostalCode: 488115115
CountryCode: US
TelephoneNumber: 9895846721
FaxNumber: 9895840106
Other Information
ProviderEnumerationDate: 05/23/2006
LastUpdateDate: 03/09/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SHOGREN HOLCOMB
AuthorizedOfficialFirstName: SARA
AuthorizedOfficialMiddleName: L.
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 5173321691
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237600000X  Y193200000X MULTI-SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter 

No ID Information.


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