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PREVOST HEALTHCARE ENTERPRISE
CHC00850-00 WATTS HEALTHCARE CORPORATION
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Covered Entity Details
Entity Name
WATTS HEALTHCARE CORPORATION
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CHC00850-00
Entity Address
10300 COMPTON AVENUE
LOS ANGELES, CA 90002
Grant Number
H80CS00850
Participating Start Date
1/1/2009
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PREVOST HEALTHCARE ENTERPRISE
Pharmacy Address
DBA WATTS PROFESSIONAL PHARMACY
9909 COMPTON AVE
LOS ANGELES, CA 90002
Pharmacy Comments
Contract Details
Approval Date
10/28/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
William D. Hobson Jr., President and CEO
(323) 568-4417
Contract Pharmacy Representative
Prevost Healthcare Enterprises
Walter J. Prevost, President
(323) 564-3218
Signed By Date
10/28/2013
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