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Organization
MABIE PHARMACY, LLC
Active
Organization
MABIE PHARMACY, LLC
Active
Other names
Forward Pharmacy of Cottage Grove
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW RYAN MABIE (OWNER)
(608) 839-3335
Entity
Organization
Contact information
Practice address
429 W COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9385
(608) 839-3335
Mailing address
429 W COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9385
(608) 839-3335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QH0100X
Health Service Clinic/Center
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9483-042
STATE LICENSE NUMBER
WI
Enumeration date
03/14/2025
Last updated
01/21/2026
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