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CH01006P Fair Haven Community Health Clinic Inc (Active)
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Main Details
Name
Fair Haven Community Health Clinic Inc
Subdivision Name
East Haven High School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019577
340B ID
CH01006P
Grant Number
H80CS00741
Additional Details
Current Program Status
Active
Registration Date
12/11/2017
Participating Start Date
1/1/2018
Participating Approval Date
12/11/2017
Last Recertification Date
2/15/2025
Contacts
Authorizing Official
Fair Haven Community Health Clinic, Inc.
SUZANNE LAGARDE, CEO
(203) 752-5129
Primary Contact
Fair Haven Community Health Clinic
Manan Dave, Compliance Officer
(203) 777-7411 Ext: 5198
Addresses
Street Address
35 Wheelbarrow Ln
East Haven, CT 06513-2003
Billing Address
Fair Haven Community Health Clinic, Inc.
374 Grand Avenue
New Haven, CT 06513
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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