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11156 - April 15, 2024 -

Date

April 15, 2024

Repair Order

11156

Facility

Facility Name

Javon Bea Hospital

Contact Name

Becky Stutzel

Billing Name

Mercy Health System Corp.

Email Address

rstutzel@mhemail.org

Phone Number

Shipping Address

8201 E. Riverside Blvd.

Rockford, IL 61114

United States

Billing Address

PO Box 31320

United States

Equipment

PO #

PO-00034878

Manufacturer

Curlin

Model #

Painsmart IOD

Serial #

217363

Asset Tag #

85122

Reported Failure

Annual PM

Anything Else