Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | San Antonio Division | ||
| Site/Hospital | Methodist Childrens Hospital | ||
| Billing | Delivery | ||
| Name | Abram.Bustamante@MHShealth.com | Name | Carlos Carrasco |
| George.Greene1@healthtrustpg.com | carlos.carrasco@mhshealth.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 8109 Fredericksburg Rd |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 2nd floor CaPE Center |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | San Antonio |
| State | TN | State | TX |
| ZIP | 37203 | ZIP | 78229 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 2 | $5.78 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 5 | $47.25 |
| Sub-Total | $53.03 | ||