Healthcare Provider Details

I. General information

NPI: 1457575656
Provider Name (Legal Business Name): SPRC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8860 COLUMBIA 100 PKWY STE 216
COLUMBIA MD
21045-2383
US

IV. Provider business mailing address

PO BOX 539
FULTON MD
20759-0539
US

V. Phone/Fax

Practice location:
  • Phone: 443-917-6500
  • Fax: 833-764-3847
Mailing address:
  • Phone: 443-917-6500
  • Fax: 833-764-3847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License NumberH0045795
License Number StateMD

VIII. Authorized Official

Name: FRANCISCO WARD
Title or Position: PHYSICIAN
Credential: DO
Phone: 443-917-6500