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CH09288AJ LIFELONG MEDICAL CARE (Active)
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Main Details
Name
LIFELONG MEDICAL CARE
Subdivision Name
Martin Luthur King Homes - Supportive Housing Program
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014322
340B ID
CH09288AJ
Grant Number
H80CS00808
Additional Details
Current Program Status
Active
Registration Date
1/4/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/16/2016
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
2942 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94703-2182
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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