MABIE PHARMACY, LLC (NPI# 1164932091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164932091 |
| Entity Type | Organization |
| Organization Name | MABIE PHARMACY, LLC |
| Other Organization Name | FORWARD PHARMACY OF DEERFIELD |
| Practice Address |
10 Liberty St # 106 Deerfield WI 53531-9458 |
| Mailing Address |
Po Box 406 Deerfield WI 53531-0406 |
| Practice Telephone | 6087641500 |
| Practice Fax Number | 6087641600 |
| Mailing Telephone | 6087641500 |
| Mailing Fax Number | 6087641600 |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2020-09-25 |
| Authorized Official Name | MR. MATTHEW RYAN MABIE (OWNER) |
| Authorized Official Telephone | 6083475420 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | Y |
| Parent Organization Name | MABIE PHARMACY, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
9485-042 | WI | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
9485-042 | WI | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
9485-042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | STATE OF WISCONSIN PHARMACY LICENSE | 9485-042 | 01 |
| Other Name | Type Code |
|---|---|
| Forward Pharmacy of Deerfield | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366952293 | Mabie Pharmacy, LLC | Pharmacy | 4880 Larson Beach Rd, Mc Farland, WI 53558-8724 | 2017-10-05 |
| 1508376682 | Mabie Pharmacy, LLC | Pharmacy | 429 W Cottage Grove Rd, Cottage Grove, WI 53527-9385 | 2017-10-03 |
| Street Address |
10 LIBERTY ST # 106 |
| City | DEERFIELD |
| State | WI |
| Zip Code | 53531-9458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982740544 | Skj Inc. | Pharmacy | 50 N Main St, Deerfield, WI 53531-9353 | 2007-01-30 |
| 1093992703 | Wade Lee Anderson | Pharmacist | 50 N Main St, Deerfield, WI 53531-9453 | 2008-01-24 |
| 1962457531 | Jennifer F Stevens | Family Medicine | 103 Lake St, Dean Medical Center, Deerfield, WI 53531-9455 | 2006-05-23 |
| 1417965260 | Dean Health Systems, Inc. | Durable Medical Equipment & Medical Supplies | 103 Lake St, Deerfield, WI 53531-9455 | 2006-08-04 |
| 1356610570 | Md Group, LLC | Pharmacy | 10 Liberty St, Suite 106, Deerfield, WI 53531-9458 | 2011-12-16 |
| 1275994808 | Melissa Bakken | Counselor | 121 Covington Cove Cir, Deerfield, WI 53531-9470 | 2016-03-09 |
| 1073913570 | Ann Saunders | Registered Nurse | 141 Covington Cove Cir, Deerfield, WI 53531-9470 | 2014-09-03 |
| 1598944233 | Deerfield Community Schools | Local Education Agency (LEA) | 300 Simonson Blvd, Deerfield, WI 53531-9543 | 2007-10-30 |
| 1518062884 | Kristin Ann Higgins | Pharmacist | 726 London Rd, Deerfield, WI 53531-9572 | 2006-09-13 |
| 1194156794 | Kelly Weisse | Registered Nurse | 322 Washburn Rd, Deerfield, WI 53531-9577 | 2013-12-06 |
| Find all providers in zip 53531 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669974309 | Kelly Decanio | Pharmacy | 1435 Lake Cook Rd, Deerfield, IL 60015-5213 | 2018-03-07 |
| 1376927699 | Walgreen Co | Pharmacy | 200 Wilmot Rd, Ms 2140, Deerfield, IL 60015-4620 | 2015-07-16 |
| 1356610570 | Md Group, LLC | Pharmacy | 10 Liberty St, Suite 106, Deerfield, WI 53531-9458 | 2011-12-16 |
| 1114200938 | Walgreens | Pharmacy | 780 Waukegan Rd, Deerfield, IL 60015-4305 | 2011-09-28 |
| 1669755484 | Bond Drug Company of Illinois, L.L.C. | Pharmacy | 780 Waukegan Rd, Deerfield, IL 60015-4305 | 2011-09-28 |
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| 1902417207 | Ipack Pharmacy LLC | Pharmacy | 17000 W North Ave Ste 108w, Brookfield, WI 53005-4423 | 2020-08-11 |
| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.