Innosonian, Inc
Innosonian, Europe
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| HCA Order Form |
| Division | Capital Division | ||
| Site/Hospital | Chippenham | ||
| Billing | Delivery | ||
| Name | Mathew.Huddleston@hcahealthcare.com | Name | Debbie Keeys |
| George.Greene1@healthtrustpg.com | Debbie.keeys@hcahealthcare.com | ||
| Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 7101 Jahnke Rd |
| Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | Attn: Debbie Keeys, Clinical Education |
| Address Line 3 | Suite 1100 | Address Line 3 | |
| City | Nashville | City | Richmond |
| State | TN | State | VA |
| ZIP | 37203 | ZIP | 23225 |
| Items to Order | |||
| Code | Description | Quantity | Total ($) |
| S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 5 | $8.30 |
| C17001 | Brayden Baby/Infant Replacement Lung (single) | 3 | $29.76 |
| A99003 | Brayden Power Adaptor for Adult & Baby, 110v, 8ft cord, U.S. Plug | 2 | $29.30 |
| Sub-Total | $67.36 | ||