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HCA Order Form |
Division | South Atlantic Division | ||
Site/Hospital | Memorial Health | ||
Billing | Delivery | ||
Name | rellie.lorenzo@hcahealthcare.com | Name | Valerie Pittman |
George.Greene1@healthtrustpg.com | Valerie.Pittman@hcahealthcare.com | ||
Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | One Meadows Parkway |
Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
Address Line 3 | Suite 1100 | Address Line 3 | |
City | Nashville | City | Vidalia |
State | TN | State | GA |
ZIP | 37203 | ZIP | 30474 |
Items to Order | |||
Code | Description | Quantity | Total ($) |
A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 1 | $14.65 |
Sub-Total | $14.65 |