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11143 - April 4, 2024 -

Date

April 4, 2024

Repair Order

11143

Facility

Facility Name

Jackson Madison County Hospital

Contact Name

Jackson Madison Cty Hospital Cliff Harris 1190573

Billing Name

Agiliti Healthcare Inc

Email Address

cliff.harris@agilitihealth.com

Phone Number

Shipping Address

620 Skyline Drive

Jackson, TN 38301

United States

Billing Address

11095 Viking Dr.

United States

Equipment

PO #

4700060210

Manufacturer

Philips

Model #

MX-40

Serial #

US096A4869

Asset Tag #

2058287

Reported Failure

Lead only connect intermittently

Anything Else