Fair Haven Community Health Clinic Inc
NPI 1346984838 · Community/Retail Pharmacy · New Haven, CT
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Fair Haven Community Health Clinic Inc is a Community/Retail Pharmacy organization in New Haven, CT (NPI 1346984838).
Provider details
- NPI number
- 1346984838
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Bain Patrie, Credentialing Manager(203) 777-7411
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Fair Haven Community Health Care
- Doing business as
- Grand Pharmacy 111
- Doing business as
- Grand Pharmacy 111
Registry dates
- Enumerated
- 2022-04-21
- Last updated
- 2024-11-12
- Certified
- 2024-11-12
Frequently asked questions
- What is Fair Haven Community Health Clinic Inc's NPI number?
- Fair Haven Community Health Clinic Inc's National Provider Identifier (NPI) is 1346984838, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fair Haven Community Health Clinic Inc?
- Fair Haven Community Health Clinic Inc is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Fair Haven Community Health Clinic Inc located?
- Fair Haven Community Health Clinic Inc's practice location on file with NPPES is 111 Grand Ave, New Haven, CT 06513-3907.
- What is Fair Haven Community Health Clinic Inc's phone number?
- The practice phone number listed in the NPPES registry for Fair Haven Community Health Clinic Inc is (203) 777-7411.
- Does Fair Haven Community Health Clinic Inc accept Medicare?
- Fair Haven Community Health Clinic Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Fair Haven Community Health Clinic Inc?
- The authorized official listed on Fair Haven Community Health Clinic Inc's NPPES record is Bain Patrie, Credentialing Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fair Haven Community Health Clinic Inc's NPI active?
- Yes — Fair Haven Community Health Clinic Inc's NPI (1346984838) is active in the NPPES registry as of the last update on 2024-11-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.