NPIMap

Organization Active NPI

Fair Haven Community Health Clinic, Inc

Doing business as Grand Pharmacy

  • Community/Retail Pharmacy
  • Branford, CT
National Provider Identifier
1891678546
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FAIR HAVEN COMMUNITY HEALTH CLINIC, INC
Doing business as
Grand Pharmacy
Practice address
221 W Main St
Branford, CT 06405-4088
Phone
(203) 777-7411
NPI assigned
Jul 29, 2025
Last updated
Jul 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

221 W Main St
Branford, CT 06405-4088

Mailing address

221 W Main St
Branford, CT 06405-4088
Phone (203) 777-7411

Other names 1

  • Grand Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fair Haven Comm Health10 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.

NPI Registry JSON

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1891678546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054088",
            "telephone_number": "203-777-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054088",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR HAVEN COMMUNITY HEALTH CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-13",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; 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.