Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Continental Division | ||
| Site/Hospital | HCA Healthcare Center for Clinical Advancement | ||
| Billing | Delivery | ||
| Name | Scott.Bartholomew@HealthONEcares.com | Name | Scott Bartholomew |
| George.Greene1@healthtrustpg.com | Scott.Bartholomew@HealthONEcares.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 333 W. Hampden Ave |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | Suite 200 |
| Address Line 3 | Suite 1100 | Address Line 3 | . |
| City | Nashville | City | Englewood |
| State | CO | State | CO |
| ZIP | 37203 | ZIP | 80110 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 4 | $39.68 |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 30 | $49.80 |
| C17006 | Brayden Baby/Infant Double Filter (Pack of 5) | 1 | $29.77 |
| Sub-Total | $119.25 | ||