# MABIE PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Forward Pharmacy of Cottage Grove
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508376682
- **Authorized official:** MR. MATTHEW RYAN MABIE RPH (OWNER)
- **Authorized official phone:** (608) 347-5420

## Contact information

- **Practice address:** 429 W COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9385
- **Practice address phone:** (608) 839-3335
- **Practice address fax:** (608) 839-3336
- **Mailing address:** 429 W COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9385
- **Mailing address phone:** (608) 839-3335
- **Mailing address fax:** (608) 839-3336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9483-042 | WI | Yes |
| 3336L0003X | Long Term Care Pharmacy | 9483-042 | WI | — |
| 3336S0011X | Specialty Pharmacy | 9483-042 | WI | — |

## Other

- **Enumeration date:** 10/03/2017
- **Last updated:** 08/29/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1508376682 | — | WI |
| 01 | — | 9483-042 | STATE LICENSE NUMBER | WI |