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CH09288BS LIFELONG MEDICAL CARE (Approved)
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Main Details
Name
LIFELONG MEDICAL CARE
Subdivision Name
LifeLong Brookside San Pablo Dental Care
Type
HRSA-Funded Health Center
Site ID
BPS-H80-037531
340B ID
CH09288BS
Grant Number
H80CS00808
Additional Details
Current Program Status
Approved
Registration Date
4/4/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/6/2025
Last Recertification Date
Contacts
Authorizing Official
Lifelong Medical Care
Cecilia Aviles, Chief Executive Officer
(415) 812-1585
Primary Contact
Lifelong Medical Care
Ka Tung Hui, Pharmacy director
(510) 981-3248
Addresses
Street Address
2023 Vale Rd, Ste 114
San Pablo, CA 94806-3891
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
June 2025
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