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11174 - April 25, 2024 -

Date

April 25, 2024

Repair Order

11174

Facility

Facility Name

Jackson Madison County Hospital

Contact Name

Jackson Madison Cty Hospital Cliff Harris 1190573

Billing Name

Agiliti Health

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 #

4700060947

Manufacturer

Philips

Model #

MX-40

Serial #

US09687602

Asset Tag #

2058277

Reported Failure

Battery clip is broken

Anything Else