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HCA Order Form
Division Capital Division
Site/Hospital LG- Alleghany
Billing Delivery
Name Mathew.Huddleston@hcahealthcare.com Name Linda Thomas
Email George.Greene1@healthtrustpg.com Email Linda.Thomas@hcahealthcare.com
Address Line 1 Clinical Education Financial Reporting Address Line 1 LG Alleghany, Education Department
Address Line 2 Clinical Education Financial Reporting Address Line 2 PO Box 7, 1 ARH Lane
Address Line 3 Suite 1100 Address Line 3 Attn: Linda Thomas
City Nashville City Low Moor
State TN State VA
ZIP 37203 ZIP 24457
Items to Order
Code Description Quantity Total ($)
C99008 Brayden Premium Urethane Adult Lung Kit (Pack of 6) 1 $88.20
C17001 Brayden Baby/Infant Replacement Lung (single) 3 $28.35
S17013 Brayden Baby/Infant Replacement Airway Tube (single) 2 $5.78
  Sub-Total $122.33