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CH09288BC Lifelong Medical Care (Active)
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Main Details
Name
Lifelong Medical Care
Subdivision Name
LifeLong Street Medicine Van #1
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032194
340B ID
CH09288BC
Grant Number
H80CS00808
Additional Details
Current Program Status
Active
Registration Date
4/5/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/6/2023
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
2730 Adeline St
Oakland, CA 94607-2408
Billing Address
Lifelong Medical Care Street Medicine
2344 Sixth Street
Berkeley, CA 94710
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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