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11029 - February 21, 2024 -

Date

February 21, 2024

Repair Order

11029

Facility

Facility Name

Northwest Health La Porte

Contact Name

Bob Smith

Billing Name

Northwest Health - La Porte

Email Address

r.smith@nwhealthin.com

Phone Number

Shipping Address

1331 State Street

La Porte, IN 46350

United States

Billing Address

PO BOX 1690

United States

Equipment

PO #

215910000700

Manufacturer

Precision Medical

Model #

PM5300

Serial #

00028726

Asset Tag #

2513

Reported Failure

2 year blender overhaul

Anything Else