Organization
ACTIVSTYLE, LLC
Active
Parent organization
ACTIVSTYLE HOLDING COMPANY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACTIVSTYLE HOLDING COMPANY
Authorized official
DARRELL DOUGLAS RAWLINGS (CEO)
(612) 895-7815
Entity
Organization
Contact information
Practice address
1055 WESTGATE DR STE 100, SAINT PAUL, MN 55114-1451
(800) 651-6223
(866) 896-7171
Mailing address
1055 WESTGATE DR STE 100, SAINT PAUL, MN 55114-1451
(800) 651-6223
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004268844
—
CT
05
—
0048074
—
MT
05
—
014083000
—
MD
05
—
1013449
—
VT
05
—
101373387
—
VA
05
—
101858880 0002
—
PA
05
—
1021830
—
AK
05
—
124008100
—
WY
05
—
1409928
—
LA
05
—
1417954165
—
IA
05
—
1417954165
—
MN
05
—
166866
—
AL
05
—
183206
—
AZ
05
—
200106290A
—
OK
05
—
200219460 A
—
IN
05
—
2227423
—
OH
05
—
34951725
—
CO
05
—
4582469
—
TN
05
—
54456
—
ND
05
—
5720001
—
RI
05
—
596546
—
HI
05
—
807670400
—
ID
05
—
84532017
—
NM
05
—
9059163
—
WA
Enumeration date
07/07/2005
Last updated
11/13/2025
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