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CH09288F Lifelong Medical Care (Active)
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Main Details
Name
Lifelong Medical Care
Subdivision Name
LIFELONG DENTAL CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005648
340B ID
CH09288F
Grant Number
H80CS00808
Additional Details
Current Program Status
Active
Registration Date
3/4/2008
Participating Start Date
4/1/2008
Participating Approval Date
3/5/2008
Last Recertification Date
2/14/2025
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
1860 ALCATRAZ AVE
BERKELEY, CA 94703-2715
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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