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HCA Order Form |
Division | San Antonio Division | ||
Site/Hospital | Methodist Childrens Hospital | ||
Billing | Delivery | ||
Name | Abram.Bustamante@MHShealth.com | Name | Abram Bustamante |
George.Greene1@healthtrustpg.com | abram.bustamante@mhshealth.com | ||
Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 8109 Fredericksburg Rd |
Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 2nd floor CAPE center |
Address Line 3 | Suite 1100 | Address Line 3 | |
City | Nashville | City | San Antonio |
State | TN | State | TX |
ZIP | 37203 | ZIP | 78229 |
Items to Order | |||
Code | Description | Quantity | Total ($) |
A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 4 | $58.60 |
C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 1 | $88.20 |
Sub-Total | $146.80 |