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CH09288E Lifelong Medical Care (Active)
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Main Details
Name
Lifelong Medical Care
Subdivision Name
WEST BERKELEY FAMILY PRACTICE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001325
340B ID
CH09288E
Grant Number
H80CS00808
Additional Details
Current Program Status
Active
Registration Date
10/1/1997
Participating Start Date
10/1/1997
Participating Approval Date
4/19/2004
Last Recertification Date
2/18/2025
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
837 Addison St
BERKELEY, CA 94710-2006
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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ADMIN CORREC - WAS CH09288011, COMBINED WITH CH09288013
08/22/2005
April 2025
April 2025
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