Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | TriStar Division | ||
| Site/Hospital | TriStar CCA | ||
| Billing | Delivery | ||
| Name | Matthew.Thomas4@hcahealthcare.com | Name | Carlos Reyes |
| George.Greene1@healthtrustpg.com | Carlos.Reyes@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 5380 Hickory Hollow Pkwy |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | Suite 200 |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Antioch |
| State | TN | State | TN |
| ZIP | 37203 | ZIP | 37013 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C99008 | Brayden Premium Urethane Adult Lung Kit (Pack of 6) | 3 | $264.60 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 7 | $66.15 |
| $0.00 | |||
| Sub-Total | $330.75 | ||