MEDICARE: RADIUS LIVING RX, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1972116671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIUS LIVING RX, LP

Provider Business Mailing Address
First Line	:	130 WABASHA ST S STE 100
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55107-1819
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 WABASHA ST S STE 100
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55107-1819
Country	:	US
Telephone Number	:	651-829-2240
Fax Number	:	651-829-2250

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LANE SIEMAN
Credential	:
Telephone Number	:	651-829-2240

Provider Enumeration Date	:	08/24/2020
Last Update Date	:	12/19/2025

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