MEDICARE: SIMPLY RESTORE BEAUTY, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1346172814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLY RESTORE BEAUTY, LLC

Provider Business Mailing Address
First Line	:	10149 TWO NOTCH RD STE E
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29229-4213
Country	:	US
Telephone Number	:	803-201-2296
Fax Number	:

Provider Business Practice Location Address
First Line	:	10149 TWO NOTCH RD STE E
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29229-4213
Country	:	US
Telephone Number	:	866-877-2552
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGING MEMBER
Name	:	THREASA M WHITE
Credential	:
Telephone Number	:	866-877-2552

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/02/2026

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