# ANDRES L. RAGO MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114096161
- **Authorized official:** DR. ANDRES L. RAGO MD (PRESIDENT)
- **Authorized official phone:** (304) 862-4611

## Contact information

- **Practice address:** 135 MAIN STREET, KEYSTONE, WV 24852
- **Practice address phone:** (304) 862-4611
- **Practice address fax:** (304) 862-4611
- **Mailing address:** HC 52 BOX 135, KEYSTONE, WV 24852-7501
- **Mailing address phone:** (304) 862-4611
- **Mailing address fax:** (304) 862-4611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11441 | WV | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 03/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0042438000 | — | WV |
| 01 | — | 1300188 | CAREMARK | WV |