Organization Active NPI

Mabie Pharmacy, LLC

Doing business as Forward Pharmacy of Deerfield

  • Community/Retail Pharmacy
  • Deerfield, WI
National Provider Identifier
1164932091
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
9485-042 Issued in WI
Legal business name
MABIE PHARMACY, LLC
Doing business as
Forward Pharmacy of Deerfield
Practice address
10 Liberty St # 106
Deerfield, WI 53531-9458
Phone
(608) 764-1500
Fax
(608) 764-1600
NPI assigned
Oct 5, 2017
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MABIE PHARMACY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Matthew Ryan Mabie, RPHNPI 1396788741
Title
Owner
Phone
(608) 347-5420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 9485-042 WI Primary
Long Term Care Pharmacy 3336L0003X 9485-042 WI
Specialty Pharmacy 3336S0011X 9485-042 WI

Addresses

Primary practice location

10 Liberty St # 106
Deerfield, WI 53531-9458

Mailing address

PO Box 406
Deerfield, WI 53531-0406
Phone (608) 764-1500

Other identifiers 2

IdentifierTypeStateIssuer
1164932091MedicaidWI
9485-042OtherWISTATE OF WISCONSIN PHARMACY LICENSE

Other names 1

  • Forward Pharmacy of Deerfield Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2270185Forward Pharmacy of Deerfield10 Liberty St, Deerfield, WI 53531Certificate of waiverOct 10, 2026

National Provider Directory

National Provider Directory
Tax ID family
Mabie Pharmacy LLC7 organizations share this tax ID, including this one
Part of
Mabie Pharmacy LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10 Liberty St
#106
Deerfield, WI 53531
Phone (608) 764-1500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1164932091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406",
            "city": "DEERFIELD",
            "state": "WI",
            "postal_code": "535310406",
            "telephone_number": "608-764-1500",
            "fax_number": "608-764-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LIBERTY ST # 106",
            "city": "DEERFIELD",
            "state": "WI",
            "postal_code": "535319458",
            "telephone_number": "608-764-1500",
            "fax_number": "608-764-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MABIE PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MABIE PHARMACY, LLC",
        "enumeration_date": "2017-10-05",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "MABIE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-347-5420",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9485-042",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "9485-042",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "WI",
            "license": "9485-042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164932091",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN PHARMACY LICENSE",
            "identifier": "9485-042",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forward Pharmacy of Deerfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deerfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.