Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Central West Texas Division | ||
| Site/Hospital | Del Sol Medical Ctr | ||
| Billing | Delivery | ||
| Name | lisa.everett@stdavids.com | Name | Jimmy Zambrano or Elizabeth Varela |
| George.Greene1@healthtrustpg.com | elizabeth.varela@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | DS Training & Development |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 10555 Vista del Sol Suite 100 |
| Address Line 3 | Suite 1100 | Address Line 3 | Building #3 |
| City | Nashville | City | El Paso |
| State | TN | State | TX |
| ZIP | 37203 | ZIP | 79925 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| [980] | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 1 | $88.20 |
| [980] | Brayden Baby/Infant Replacement Lung (single) | 6 | $56.70 |
| [980] | $0.00 | ||
| Sub-Total | $144.90 | ||