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Organization

ACTIVSTYLE, INC

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
241 CHURCH ST, SUITE G, PUTNAM, CT 06260-1548
(612) 928-6822
(866) 896-7171
Mailing address
1055 WESTGATE DR STE 100, SAINT PAUL, MN 55114-1451
(888) 280-8632

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
5720001
RI
Enumeration date
07/10/2012
Last updated
08/19/2025
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