Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Gulf Coast Division | ||
| Site/Hospital | Corpus Christi Medical Center Doctors Regional | ||
| Billing | Delivery | ||
| Name | sarah.prial@hcahealthcare.com | Name | Charisse Leach |
| George.Greene1@healthtrustpg.com | joy.leach@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 3315 S. Alameda St |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Corpus Christs |
| State | TN | State | TX |
| ZIP | 37203 | ZIP | 78411 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 10 | $28.90 |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 10 | $15.80 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 10 | $94.50 |
| C17006 | Brayden Baby/Infant Double Filter (Pack of 5) | 2 | $56.70 |
| $0.00 | |||
| Sub-Total | $195.90 | ||