# MOUNTAINSIDE MEDICAL, LLC

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

## Provider details

- **NPI number:** 1487482543
- **Authorized official:** CARSON C GOMEZ APRN (OWNER)
- **Authorized official phone:** (406) 303-9781

## Contact information

- **Practice address:** 704 MAIN ST, STEVENSVILLE, MT 59870-2828
- **Practice address phone:** (406) 303-9781
- **Practice address fax:** (880) 440-2614
- **Mailing address:** 704 MAIN ST, STEVENSVILLE, MT 59870-2828
- **Mailing address phone:** (406) 303-9781
- **Mailing address fax:** (880) 440-2614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/22/2024
- **Last updated:** 12/10/2025