<Unavail>
LBN: My Fair Haven Pharmacy Llc
<Unavail> is an health care organization with primary practice located at 72 Grand Ave , New Haven CT 06513. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
My Fair Haven Pharmacy Llc can be contacted via phone (203) 498-3479, or through Varma, Manthena V via phone (203) 498-3479.
Contact Information
Primary practice address
72 Grand Ave
New Haven CT 06513
Phone: (203) 498-3479
Fax: (203) 498-8000
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PCY.0002315 | Connecticut |
Profile Details
| NPI number | 1568839876 |
|---|---|
| LBN Legal business name | My Fair Haven Pharmacy Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Varma, Manthena V |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 24th, 2015 |
| Last updated | Apr 1st, 2016 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568839876 | NPPES |
| Connecticut | MEDICAID | 008061384 | |
| Connecticut | Other | 008064135 |
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