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
—
—
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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