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The Q2 2025 registration window for covered entities is open from 4/1/2025 - 4/15/2025.
CH092880 Lifelong Medical Care (Active)
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Main Details
Name
Lifelong Medical Care
Subdivision Name
LIFELONG MEDICAL CARE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-002401
340B ID
CH092880
Grant Number
H80CS00808
Additional Details
Current Program Status
Active
Registration Date
8/22/2005
Participating Start Date
9/9/2005
Participating Approval Date
8/22/2005
Last Recertification Date
2/13/2025
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
2344 6th St
Berkeley, CA 94710-2412
Billing Address
LIFELONG MEDICAL CARE
PO BOX 11247
BERKELEY, CA 94712-2247
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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