MEDICARE: SELECT HEARING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1205771623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT HEARING LLC

Provider Business Mailing Address
First Line	:	324 BROADWAY ST STE 210
Second Line	:
City	:	ALEXANDRIA
State	:	MN
Zip	:	56308-2688
Country	:	US
Telephone Number	:	320-815-9065
Fax Number	:

Provider Business Practice Location Address
First Line	:	324 BROADWAY ST STE 210
Second Line	:
City	:	ALEXANDRIA
State	:	MN
Zip	:	56308-2688
Country	:	US
Telephone Number	:	320-815-9065
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KATHEREINE MARIE VANDERWEYST
Credential	:	HIS
Telephone Number	:	320-815-9065

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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