MEDICARE: LE POSTICHE, 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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1285598656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LE POSTICHE, LLC

Provider Business Mailing Address
First Line	:	13109 BOX CANYON RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-6203
Country	:	US
Telephone Number	:	918-344-8843
Fax Number	:

Provider Business Practice Location Address
First Line	:	5645 N PENNSYLVANIA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7769
Country	:	US
Telephone Number	:	405-849-5779
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREW MARYADI
Credential	:
Telephone Number	:	918-344-8843

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/17/2025

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Directions to “LE POSTICHE, LLC ” Practice Location

Language	Start Address	Practice Location

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