Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | North Texas Division | ||
| Site/Hospital | NTXD HHCCA | ||
| Billing | Delivery | ||
| Name | marlo.cooper@medicalcityhealth.com | Name | Marlo Cooper |
| George.Greene1@healthtrustpg.com | marlo.cooper@medicalcityhealth.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | HCA Healthcare Center for Clinical Advancement c/o Marlo Cooper |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 3201 Dallas Parkway |
| Address Line 3 | Suite 1100 | Address Line 3 | 9th floor Suite 900 |
| City | Nashville | City | Frisco |
| State | TN | State | TX |
| ZIP | 37203 | ZIP | 75034 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 10 | $153.80 |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 25 | $41.50 |
| A17002 | Brayden Baby/Infant Blanket | 2 | $33.08 |
| A17001 | Brayden Baby/Infant Cotton Diaper | 2 | $33.08 |
| C17006 | Brayden Baby/Infant Double Filter (Pack of 5) | 1 | $29.77 |
| S16402 | Brayden Pro Adult Body Skin Magnet | 4 | $16.56 |
| S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 10 | $30.30 |
| A17002 | Brayden Baby/Infant Blanket | 2 | $33.08 |
| Sub-Total | $371.17 | ||