Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | South Atlantic Division | ||
| Site/Hospital | Memorial Health | ||
| Billing | Delivery | ||
| Name | Susan.Burke@hcahealthcare.com | Name | Katy Faircloth |
| George.Greene1@healthtrustpg.com | Katy.Faircloth@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 4700 Waters Ave |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | Memorial Health: EDUCATION DEPT: BUILDING 600 |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Savannah |
| State | TN | State | GA |
| ZIP | 37203 | ZIP | 31404 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| [980] | Brayden Baby/Infant Replacement Airway Tube (single) | 6 | $17.34 |
| [980] | Brayden Baby/Infant Artificial Lung Air Guide | 5 | $7.90 |
| [980] | Brayden Adult Lung Kit Version A04 (Pack of 24) | 1 | $47.25 |
| [980] | Brayden Pro Adult Body Skin Magnet | 5 | $19.70 |
| [980] | $0.00 | ||
| Sub-Total | $92.19 | ||