Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Central West Texas Division | ||
| Site/Hospital | St. David’s Medical Center | ||
| Billing | Delivery | ||
| Name | Robert.Williams@HCAhealthcare.com | Name | Bob Williams |
| George.Greene1@healthtrustpg.com | Robert.Williams@HCAhealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 1201B W. Louis Henna Blvd. |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Austin |
| State | TN | State | TX |
| ZIP | 37203 | ZIP | 78681 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| [980] | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 1 | $14.65 |
| [980] | Brayden Baby/Infant Replacement Lung (single) | 4 | $37.80 |
| [980] | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 1 | $88.20 |
| [980] | Brayden Baby/Infant Artificial Lung Air Guide | 1 | $1.58 |
| [980] | $0.00 | ||
| Sub-Total | $142.23 | ||