NPIMap

Organization Active NPI

Fair Haven Community Health Clinic Inc

  • Pharmacy
  • New Haven, CT
National Provider Identifier
1306787684
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
FAIR HAVEN COMMUNITY HEALTH CLINIC INC
Practice address
374 Grand Ave
New Haven, CT 06513-3733
Phone
(203) 777-7411
NPI assigned
Apr 2, 2026
Last updated
Apr 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bain Patrie
Title
Credentialing Manager
Phone
(203) 777-7411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

374 Grand Ave
New Haven, CT 06513-3733

Mailing address

374 Grand Ave
Grand Pharmacy 374
New Haven, CT 06513-3733
Phone (203) 777-7411

National Provider Directory

National Provider Directory
Tax ID family
Suzanna L Lin10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

374 Grand Ave
New Haven, CT 06513
Phone (203) 752-5203

374 Grand Ave
#374
New Haven, CT 06513

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1306787684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "address_2": "GRAND PHARMACY 374",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR HAVEN COMMUNITY HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "PATRIE",
        "authorized_official_first_name": "BAIN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "203-777-7411"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.