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CH09288W LIFELONG MEDICAL CARE (Active)
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Main Details
Name
LIFELONG MEDICAL CARE
Subdivision Name
LifeLong Dental Van
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014568
340B ID
CH09288W
Grant Number
H80CS00808
Additional Details
Current Program Status
Active
Registration Date
7/10/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/20/2015
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
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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June 2025
June 2025
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