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HCA Order Form |
Division | Capital Division | ||
Site/Hospital | Johnston Willis | ||
Billing | Delivery | ||
Name | Tracy.Harrell@hcahealthcare.com | Name | Michelle Ford |
George.Greene1@healthtrustpg.com | Michelle.Ford2@hcahealthcare.com | ||
Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 1401 Johnston Willis Dr |
Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
Address Line 3 | Suite 1100 | Address Line 3 | |
City | Nashville | City | Richmond |
State | TN | State | VA |
ZIP | 37203 | ZIP | 23235 |
Items to Order | |||
Code | Description | Quantity | Total ($) |
C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | $0.00 | |
S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 6 | $9.00 |
S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 6 | $16.50 |
$0.00 | |||
Sub-Total | $25.50 |