Active NPI
M.a.R.Y. Medical, LLC
Doing business as ActivStyle
- Durable Medical Equipment & Medical Supplies
- Fresno, CA
National Provider Identifier
1396786356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 50800
- Legal business name
- M.A.R.Y. MEDICAL, LLC
- Doing business as
- ActivStyle
- Practice address
- 4656 E Dakota Ave
Suite 104
Fresno, CA 93726-4727 - Phone
- (559) 440-6808
- Fax
- (559) 456-1848
- NPI assigned
- Jun 9, 2006
- Last updated
- Aug 19, 2025
- Organization subpart
- Yes
- Parent organization
- ACTIVSTYLE HOLDING COMPANY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Darrell Douglas Rawlings
- Title
- Ceo
- Phone
- (612) 895-7815
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 50800 | CA | Primary |
Addresses
Primary practice location
4656 E Dakota Ave
Suite 104
Fresno, CA 93726-4727
Mailing address
1055 Westgate Dr Ste 100
Saint Paul, MN 55114-1451
Phone (888) 280-8632
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9974340 | Medicaid | CA |
Other names 1
- ActivStyle
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930041053 | CA | DME Supplier - Medical Supply Company | 7113048380 | Practice locations: Fresno, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Activstyle | Commodes, Urinals, Bedpans|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Surgical Dressings | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
4656 E Dakota Ave
Ste 104
Fresno, CA 93726
Phone (559) 440-6808
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1755561600000",
"number": "1396786356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 WESTGATE DR STE 100",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141451",
"telephone_number": "888-280-8632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4656 E DAKOTA AVE",
"address_2": "SUITE 104",
"city": "FRESNO",
"state": "CA",
"postal_code": "937264727",
"telephone_number": "559-440-6808",
"fax_number": "559-456-1848"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "M.A.R.Y. MEDICAL, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ACTIVSTYLE HOLDING COMPANY",
"enumeration_date": "2006-06-09",
"last_updated": "2025-08-19",
"certification_date": "2025-08-19",
"status": "A",
"authorized_official_last_name": "RAWLINGS",
"authorized_official_first_name": "DARRELL",
"authorized_official_middle_name": "DOUGLAS",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "612-895-7815"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "CA",
"license": "50800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9974340",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ActivStyle",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "ActivStyle",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.