MEDICARE: RYAN O'MALLEY LLC

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	332BC3200X	Customized Equipment (DME)	6921	SC
2	261QD0000X	Dental Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1831503580	OTHER		INDIVIDUAL NPI
2	1710290663	OTHER	SC	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1750705323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYAN O'MALLEY LLC

Provider Business Mailing Address
First Line	:	419 SE MAIN ST
Second Line	:	SUITE 100
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-2673
Country	:	US
Telephone Number	:	864-962-4140
Fax Number	:	864-962-4142

Provider Business Practice Location Address
First Line	:	419 SE MAIN ST
Second Line	:	SUITE 100
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-2673
Country	:	US
Telephone Number	:	864-962-4140
Fax Number	:	864-962-4142

Authorized Official
Title or Position	:	FORMER OM
Name	:	IVEY LINDSAY
Credential	:
Telephone Number	:	864-962-4140

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	08/04/2020

Similar Medicare Providers

1942659768 — BRITTANY SEGRIFF
Practice Location Address:

419 SE MAIN ST STE 102
SIMPSONVILLE, SC
29681-2673

Practice Phone: 864-469-3268
Practice Fax:

1861801326 — DR. ALLIE SANSBURY HAMSTEAD D.C.
Practice Location Address:

419 SE MAIN ST
SIMPSONVILLE, SC
29681-2673

Practice Phone: 864-590-0845
Practice Fax:

1124437686 — DR. MICHAEL CHARLES HAMSTEAD D.C.
Practice Location Address:

419 SE MAIN ST
SIMPSONVILLE, SC
29681-2673

Practice Phone: 304-281-2292
Practice Fax:

1225434731 — HAMSTEAD CHIROPRACTIC CENTERS
Practice Location Address:

419 SE MAIN ST , SUITE 200
SIMPSONVILLE, SC
29681-2673

Practice Phone: 864-881-3693
Practice Fax: 864-881-3693

1750752150 — POOLE FAMILY EYE CARE OF SIMPSONVILLE
Practice Location Address:

419 SE MAIN ST , STE 301
SIMPSONVILLE, SC
29681-2673

Practice Phone: 864-436-1234
Practice Fax: 864-963-7319

1720583859 — LORENE R HEUVELMAN-HUTCHINSON MS, EDS, PSYD
Practice Location Address:

419 SE MAIN ST STE 203A
SIMPSONVILLE, SC
29681-2673

Practice Phone: 678-230-0476
Practice Fax:

Directions to “RYAN O'MALLEY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.