Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Mountain Division | ||
| Site/Hospital | Cache Valley Hospital | ||
| Billing | Delivery | ||
| Name | Michelle.Husberg@hcahealthcare.com | Name | Kristi Hall |
| George.Greene1@healthtrustpg.com | Kristi.Hall@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 2380 N 400 E |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Logan |
| State | TN | State | Utah |
| ZIP | 37203 | ZIP | 84341 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | $0.00 | |
| C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 1 | $88.20 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 2 | $18.90 |
| Sub-Total | $107.10 | ||