Fair Haven Community Health Clinic INC
Pharmacy, Community/Retail Pharmacy in New Haven, CT. Organization (NPI-2).
NPI number1346984838
StatusActive
Last updated in NPPESNov 12, 2024
Details
- NPI
- 1346984838
- Entity type
- Organization (NPI-2)
- Legal business name
- Fair Haven Community Health Clinic INC
- Organization subpart
- No
- Enumeration date
- Apr 21, 2022
- Certification date
- Nov 12, 2024
- Last updated
- Nov 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
Other names
- Grand Pharmacy 111 (Doing Business As)
- Fair Haven Community Health Care (Doing Business As)
Practice location
111 Grand AveNew Haven, CT 06513-3907
Phone 203-777-7411
Mailing address
221 W Main StBranford, CT 06405-4022
Phone 203-871-4188
Authorized official
Bain Patrie
Credentialing Manager
2037777411
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All 30 Community/Retail Pharmacy providers in New Haven · All 10,633 providers in New Haven
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