Healthcare Provider Details

I. General information

NPI: 1215025846
Provider Name (Legal Business Name): WILLIAM RALPH SEBASTIAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 MACON ROAD
COLUMBUS GA
31907
US

IV. Provider business mailing address

239 PINTAIL DR
CATAULA GA
31804-4151
US

V. Phone/Fax

Practice location:
  • Phone: 706-563-6844
  • Fax: 706-563-0483
Mailing address:
  • Phone: 706-327-4298
  • Fax: 706-563-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13352
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number13352
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number13352
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number13352
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: