Organization
ACTIVSTYLE, LLC
Active
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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