Healthcare Provider Details

I. General information

NPI: 1346172814
Provider Name (Legal Business Name): SIMPLY RESTORE BEAUTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10149 TWO NOTCH RD STE E
COLUMBIA SC
29229-4213
US

IV. Provider business mailing address

10149 TWO NOTCH RD STE E
COLUMBIA SC
29229-4213
US

V. Phone/Fax

Practice location:
  • Phone: 866-877-2552
  • Fax:
Mailing address:
  • Phone: 866-877-2552
  • Fax: 866-877-2552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: THREASA M WHITE
Title or Position: OWNER/MANAGING MEMBER
Credential:
Phone: 803-201-2296