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HCA Order Form |
Division | Gulf Coast Division | ||
Site/Hospital | HCA Houston Healthcare West | ||
Billing | Delivery | ||
Name | sarah.prial@hcahealthcare.com | Name | Karen King |
George.Greene1@healthtrustpg.com | karen.king@hcahealthcare.com | ||
Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 12141 Richmond Avenue |
Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
Address Line 3 | Suite 1100 | Address Line 3 | |
City | Nashville | City | Houston |
State | TN | State | TX |
ZIP | 37203 | ZIP | 77082 |
Items to Order | |||
Code | Description | Quantity | Total ($) |
C99007 | Brayden Adult Lung Kit Version A04 (Pack of 24) | 1 | $47.25 |
$0.00 | |||
Sub-Total | $47.25 |