Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | South Atlantic Division | ||
| Site/Hospital | Memorial Hospital Jacksonville | ||
| Billing | Delivery | ||
| Name | rellie.lorenzo@hcahealthcare.com | Name | Kathy Zoumberis |
| George.Greene1@healthtrustpg.com | Kathryn.Zoumberis@HCAHealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | Education Department |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | HCA Florida Memorial Hospital |
| Address Line 3 | Suite 1100 | Address Line 3 | 3625 University Blvd S |
| City | Nashville | City | Jacksonville |
| State | TN | State | FL |
| ZIP | 37203 | ZIP | 32216 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 6 | $56.70 |
| C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 1 | $88.20 |
| Sub-Total | $144.90 | ||