Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Mountain Division | ||
| Site/Hospital | Eastern Idaho Regional Medical Center | ||
| Billing | Delivery | ||
| Name | Michelle.Husberg@hcahealthcare.com | Name | Kirie Brown |
| George.Greene1@healthtrustpg.com | Kirie.Brown@HCAhealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 3100 Channing Way |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Idaho Falls |
| State | TN | State | Idaho |
| ZIP | 37203 | ZIP | 83404 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 3 | $28.35 |
| C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 1 | $88.20 |
| Sub-Total | $116.55 | ||