| LCA CASE NUMBER | I-200-21048-081955 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-02-17 |
| DECISION DATE | 2021-02-24 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Critical Care Physician |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Pikeville Medical Center, Inc. |
| EMPLOYER ADDRESS1 | 911 Bypass Road |
| EMPLOYER CITY | Pikeville |
| EMPLOYER STATE | KY |
| EMPLOYER POSTAL CODE | 41501 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16062183501 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Blackburn |
| EMPLOYER POC FIRST NAME | William |
| EMPLOYER POC MIDDLE NAME | Donovan |
| EMPLOYER POC JOB TITLE | CEO/VP Board of Directors |
| EMPLOYER POC ADDRESS 1 | 911 Bypass Road |
| EMPLOYER POC CITY | Pikeville |
| EMPLOYER POC STATE | KY |
| EMPLOYER POC POSTAL CODE | 41501 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16062183501 |
| EMPLOYER POC EMAIL | donovan.blackburn@pikevillehospital.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Watts |
| AGENT ATTORNEY FIRST NAME | Rachael |
| AGENT ATTORNEY MIDDLE NAME | Dawn |
| AGENT ATTORNEY ADDRESS1 | 911 Bypass Road |
| AGENT ATTORNEY CITY | Pikeville |
| AGENT ATTORNEY STATE | KY |
| AGENT ATTORNEY POSTAL CODE | 41501 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16062186562 |
| AGENT ATTORNEY EMAIL ADDRESS | rachael.watts@pikevillehospital.org |
| LAWFIRM NAME BUSINESS NAME | Pikeville Medical Center, Inc. |
| STATE OF HIGHEST COURT | KY |
|
| NAME OF HIGHEST STATE COURT | Kentucky Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 911 Bypass Road |
| LCA CASE WORKLOC1 CITY | Pikeville |
| WORKSITE COUNTY | PIKE |
| LCA CASE WORKLOC1 STATE | KY |
| WORKSITE POSTAL CODE | 41501 |
| LCA CASE WAGE RATE FROM | 463000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
