Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Capital Division | ||
| Site/Hospital | Reston Hospital | ||
| Billing | Delivery | ||
| Name | Mathew.Huddleston@hcahealthcare.com | Name | Sarah Compton |
| George.Greene1@healthtrustpg.com | sarah.compton@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 1800 Town Center Pkwy |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | Suite 120 |
| Address Line 3 | Suite 1100 | Address Line 3 | Attn: Sarah Compton, Clinical Education |
| City | Nashville | City | Reston |
| State | TN | State | VA |
| ZIP | 37203 | ZIP | 20190 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 6 | $9.48 |
| S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 6 | $17.34 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 6 | $56.70 |
| A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 2 | $29.30 |
| Sub-Total | $112.82 | ||