Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Capital Division | ||
| Site/Hospital | Henrico Doctors – Parham | ||
| Billing | Delivery | ||
| Name | Mathew.Huddleston@hcahealthcare.com | Name | Taylor Scruggs |
| George.Greene1@healthtrustpg.com | taylor.scruggs@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | Clinical Education, MOB II Suite 220 |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 7700 E. Parham Rd |
| Address Line 3 | Suite 1100 | Address Line 3 | Attn: Taylor Scruggs, Clinical Education Department |
| City | Nashville | City | Richmond |
| State | TN | State | VA |
| ZIP | 37203 | ZIP | 23294 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C17003 | Brayden Baby/Infant Body Skin | 1 | $57.75 |
| S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 3 | $8.67 |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 3 | $4.74 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 3 | $28.35 |
| Sub-Total | $99.51 | ||