My Fair Haven Pharmacy Llc
Community/Retail Pharmacy
72 Grand Ave, New Haven
Connecticut, 06513
203-498-3479 203-498-8000
My Fair Haven Pharmacy Llc is a Community/Retail Pharmacy in New Haven, Connecticut. It is located at 72 Grand Ave, New Haven and it's customer support contact number is 203-498-3479. The authorized person of My Fair Haven Pharmacy Llc is Manthena V Varma who is Member of the pharmacy and his contact number is 203-498-3479. Active license number of My Fair Haven Pharmacy Llc is PCY.0002315 for Community/Retail Pharmacy in Connecticut. My Fair Haven Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
My Fair Haven Pharmacy Llc is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
My Fair Haven Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | My Fair Haven Pharmacy Llc |
| Type: | Community/Retail Pharmacy |
| Location: | 72 Grand Ave, New Haven,
Connecticut, 06513 |
| Phone: | 203-498-3479 |
| Fax: | 203-498-8000 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Manthena V Varma |
| Position: | Member |
| Contact Number: | 203-498-3479 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1568839876 |
| NPI Enumeration Date: | 24 Aug, 2015 |
| NPI Last Update On: | 01 Apr, 2016 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for My Fair Haven Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | PCY.0002315 | Connecticut | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 008061384 | Medicaid | Connecticut | |
| 008064135 | Other | Connecticut | Medicaid Dme |
Medicare Enrollment:
My Fair Haven Pharmacy Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 2466752985 | O20151204001204 | My Fair Haven Pharmacy Llc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
| 2466752985 | O20160212000054 | My Fair Haven Pharmacy Llc | DME SUPPLIER - PHARMACY |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 72 Grand Ave,
New Haven, Connecticut |
| Zip: | 06513 |
| Phone Number: | 203-498-3479 |
| Fax Number: | 203-498-8000 |
Patients can reach My Fair Haven Pharmacy Llc at
72 Grand Ave, New Haven, Connecticut or can
call on customer care at 203-498-3479.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.