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CRENSHAW PHARMACY INC
CHC00850-07 WATTS HEALTHCARE CORPORATION
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Covered Entity Details
Entity Name
WATTS HEALTHCARE CORPORATION
Subdivision Name
JEFFERSON CRENSHAW HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC00850-07
Entity Address
3501 West Jefferson Boulevard
Los Angeles, CA 90018-3237
Grant Number
H80CS00850
Participating Start Date
1/1/2018
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
CRENSHAW PHARMACY INC
Pharmacy Address
DBA CRENSHAW PHARMACY
3631 CRENSHAW BLVD STE 111
LOS ANGELES, CA 90016-4869
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Barrett Hatches, Acting CEO
(323) 564-4331
Contract Pharmacy Representative
Crenshaw Pharmacy
Ardelan Behell, Owner
(323) 732-5555
Signed By Date
1/16/2024
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