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HCA Order Form |
Division | Gulf Coast Division | ||
Site/Hospital | HCA Houston Healthcare Kingwood | ||
Billing | Delivery | ||
Name | sarah.prial@hcahealthcare.com | Name | LaDusta Mercier |
George.Greene1@healthtrustpg.com | Ladusta.Mercier@hcahealthcare.com | ||
Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 22999 US Hwy 59 N |
Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
Address Line 3 | Suite 1100 | Address Line 3 | |
City | Nashville | City | Kingwood |
State | TN | State | TX |
ZIP | 37203 | ZIP | 77339 |
Items to Order | |||
Code | Description | Quantity | Total ($) |
A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 4 | $58.60 |
Sub-Total | $58.60 |