Provider Demographics
NPI:1275991515
Name:VOLITION GROUP CORP
Entity Type:Organization
Organization Name:VOLITION GROUP CORP
Other - Org Name:RXTREE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PASCHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:NZERUE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:786-262-6040
Mailing Address - Street 1:125 SR 436
Mailing Address - Street 2:
Mailing Address - City:FERN PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32730
Mailing Address - Country:US
Mailing Address - Phone:407-636-8733
Mailing Address - Fax:407-386-3245
Practice Address - Street 1:125 SR 436
Practice Address - Street 2:
Practice Address - City:FERN PARK
Practice Address - State:FL
Practice Address - Zip Code:32730
Practice Address - Country:US
Practice Address - Phone:407-636-8733
Practice Address - Fax:407-386-3245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH29812333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017967600Medicaid
2158916OtherPK