Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Central West Texas Division | ||
| Site/Hospital | Las Palmas Medical Ctr | ||
| Billing | Delivery | ||
| Name | jasmine.duran@stdavids.com | Name | Jasmine Duran |
| George.Greene1@healthtrustpg.com | jasmine.duran@stdavids.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | Las Palmas Training & Development |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 1700 N Oregon St. Suite 720 |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | El Paso |
| State | TN | State | TX |
| ZIP | 37203 | ZIP | 79902 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 10 | $16.60 |
| Sub-Total | $16.60 | ||