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COMMUNITY HEALTH RX #2, INC.
CH010060 FAIR HAVEN COMMUNITY HEALTH CLINIC INC
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Covered Entity Details
Entity Name
FAIR HAVEN COMMUNITY HEALTH CLINIC INC
Subdivision Name
FAIR HAVEN COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH010060
Entity Address
374 Grand Ave
New Haven, CT 06513-3733
Grant Number
H80CS00741
Participating Start Date
7/1/2003
Last Recertification Date
2/15/2025
Pharmacy Details
Pharmacy Name
COMMUNITY HEALTH RX #2, INC.
Pharmacy Address
221 W MAIN ST
BRANFORD, CT 06405-4022
Pharmacy Comments
Contract Details
Approval Date
4/5/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
SUZANNE LAGARDE, CEO
(203) 752-5129
Contract Pharmacy Representative
Community Health RX #2, Inc.
Caleb DesRosiers, President
(203) 450-4194
Signed By Date
4/5/2020
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