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HCA Order Form |
Division | North Carolina Division | ||
Site/Hospital | Mission Hospital: Main Campus | ||
Billing | Delivery | ||
Name | Thomas.Edwards4@HealthTrustWS.com | Name | Thomas Edwards |
George.Greene1@healthtrustpg.com | Thomas.Edwards4@HealthTrustWS.com | ||
Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 1 Hospital Drive Suite 6200 |
Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
Address Line 3 | Suite 1100 | Address Line 3 | |
City | Nashville | City | Asheville |
State | TN | State | NC |
ZIP | 37203 | ZIP | 28801 |
Items to Order | |||
Code | Description | Quantity | Total ($) |
S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 10 | $15.80 |
Sub-Total | $15.80 |