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
—
—
261QP2300X
Primary Care Clinic/Center
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
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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