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HCA Order Form
Division Continental Division
Site/Hospital HCA Healthcare Center for Clinical Advancement
Billing Delivery
Name Scott.Bartholomew@HealthONEcares.com Name Scott Bartholomew
Email George.Greene1@healthtrustpg.com Email Scott.Bartholomew@HealthONEcares.com
Address Line 1 Clinical Education Financial Reporting Address Line 1 333 W Hampden Ave Ste 200
Address Line 2 Clinical Education Financial Reporting Address Line 2
Address Line 3 Suite 1100 Address Line 3 .
City Nashville City Englewood
State TN State CO
ZIP 37203 ZIP 80110
Items to Order
Code Description Quantity Total ($)
A99003 Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug 8 $123.04
  Sub-Total $123.04