# BLUE SAGE MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1053799171
- **Authorized official:** LORI LABRECQUE (ACCOUNTS MANAGER)
- **Authorized official phone:** (702) 453-3799

## Contact information

- **Practice address:** 615 FAIRHURST ST, STERLING, CO 80751-4523
- **Practice address phone:** (970) 522-0122
- **Mailing address:** 3107 W COLORADO AVE, BOX 291, COLORADO SPRINGS, CO 80904-2088
- **Mailing address phone:** (702) 453-3799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | DR30054726 | CO | — |
| 208M00000X | Hospitalist Physician | DR30054726 | CO | Yes |

## Other

- **Enumeration date:** 05/08/2015
- **Last updated:** 05/08/2015