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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
MR. MATTHEW RYAN MABIE RPH (OWNER)
(608) 347-5420
Entity
Organization
Contact information
Practice address
429 W COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9385
(608) 839-3335
(608) 839-3336
Mailing address
429 W COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9385
(608) 839-3335
(608) 839-3336
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
9483-042
WI
3336L0003X
Long Term Care Pharmacy
9483-042
WI
3336S0011X
Specialty Pharmacy
9483-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508376682
—
WI
01
—
9483-042
STATE LICENSE NUMBER
WI
Enumeration date
10/03/2017
Last updated
08/29/2025
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