Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Far West Division | ||
| Site/Hospital | Good Samaritan | ||
| Billing | Delivery | ||
| Name | Elizabeth.Cabada@hcahealthcare.com | Name | Sheree Hannett |
| George.Greene1@healthtrustpg.com | Sheree.Hannett@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 2425 Samaritan Dr |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | San Jose |
| State | TN | State | CA |
| ZIP | 37203 | ZIP | 95124 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C17005 | Brayden Baby/Infant Face Shield Membrane (Pack of 10) | 1 | $6.30 |
| C17006 | Brayden Baby/Infant Double Filter (Pack of 5) | 1 | $28.35 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 10 | $94.50 |
| S16402 | Brayden Pro Adult Body Skin Magnet | 4 | $15.76 |
| C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 2 | $176.40 |
| Sub-Total | $321.31 | ||