Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | South Atlantic Division | ||
| Site/Hospital | Doctors Hospital of Augusta | ||
| Billing | Delivery | ||
| Name | Susan.Burke@hcahealthcare.com | Name | Justin Sim |
| George.Greene1@healthtrustpg.com | Justin.Sim@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | Doctors Hospital of Augusta: |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | 3651 Wheeler Road |
| Address Line 3 | Suite 1100 | Address Line 3 | EDUCATION BUILDING |
| City | Nashville | City | Augusta |
| State | TN | State | GA |
| ZIP | 37203 | ZIP | 30909 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C99007 | Brayden Adult Lung Kit Version A04 (Pack of 24) | 2 | $94.50 |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 10 | $15.80 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 10 | $94.50 |
| Sub-Total | $204.80 | ||