Organization
FAIR HAVEN COMMUNITY HEALTH CLINIC INC.
Active
Other names
Grand Pharmacy 111
Organization subpart
No
Provider details
NPI number
Authorized official
BAIN PATRIE (CREDENTIALING MANAGER)
(203) 777-7411
Entity
Organization
Contact information
Practice address
111 GRAND AVE, NEW HAVEN, CT 06513-3907
(203) 777-7411
Mailing address
111 GRAND AVE, NEW HAVEN, CT 06513-3907
(203) 777-7411
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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