Healthcare Provider Details

I. General information

NPI: 1740100841
Provider Name (Legal Business Name): YOUR TOTAL HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 CONCORD PLACE RD
IRMO SC
29063-7806
US

IV. Provider business mailing address

423 CONCORD PLACE RD
IRMO SC
29063-7806
US

V. Phone/Fax

Practice location:
  • Phone: 803-479-0413
  • Fax:
Mailing address:
  • Phone: 803-479-0413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: VEOLA R RILEY-AMAKER
Title or Position: OWNER
Credential: FNP-BC
Phone: 803-479-0413