| NPI | 1568839876 |
|---|---|
| Doing Business As | FAIR HAVEN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MANTHENA V VARMA Member 203-498-3479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT PCY.0002315) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2016-04-01 |