Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | North Florida Division | ||
| Site/Hospital | North FL Regional Med Ctr | ||
| Billing | Delivery | ||
| Name | dan.fran@hcahealthcare.com | Name | Nsg. Education (6NT) – Mary Ann Morgan & LT Graham |
| George.Greene1@healthtrustpg.com | Lenterious.Graham@HCAhealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 6500 W Newberry Rd. |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Gainsville |
| State | TN | State | Fl |
| ZIP | 37203 | ZIP | 32605 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| [980] | Brayden Baby/Infant Artificial Lung Air Guide | 10 | $16.60 |
| [980] | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 3 | $46.14 |
| [980] | Brayden Baby/Infant Replacement Airway Tube (single) | 3 | $9.09 |
| [980] | Brayden Baby/Infant Replacement Lung (single) | 5 | $49.60 |
| Sub-Total | $121.43 | ||