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HCA Order Form |
Division | North Florida Division | ||
Site/Hospital | Capital Regional Medical Ctr | ||
Billing | Delivery | ||
Name | dan.fran@hcahealthcare.com | Name | Angie Webb / Connie Henry – Nursing Education |
George.Greene1@healthtrustpg.com | angelia.webb@hcahealthcare.com | ||
Address Line 1 | Clinical Education Financial Reporting | Address Line 1 | 2626 Capital Medical Blvd |
Address Line 2 | Clinical Education Financial Reporting | Address Line 2 | |
Address Line 3 | Suite 1100 | Address Line 3 | |
City | Nashville | City | Tallahassee |
State | TN | State | FL |
ZIP | 37203 | ZIP | 32308 |
Items to Order | |||
Code | Description | Quantity | Total ($) |
S17013 | Brayden Baby/Infant Replacement Airway Tube (single) | 5 | $15.15 |
S17011 | Brayden Baby/Infant Artificial Lung Air Guide | 5 | $8.30 |
Sub-Total | $23.45 |