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CONNECTICUT CVS PHARMACY, L.L.C.
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
CONNECTICUT CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00775
2045 DIXWELL AVE.
HAMDEN, CT 06514
Pharmacy Comments
Contract Details
Approval Date
4/10/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SUZANNE LAGARDE, CEO
(203) 752-5129
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/10/2020
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