| LCA CASE NUMBER | I-200-21098-209089 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-08 |
| DECISION DATE | 2021-04-15 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-02 |
| END DATE | 2024-07-01 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | PRIME HEALTHCARE FOUNDATION SOUTHERN REGIONAL, LLC |
| TRADE NAME DBA | SOUTHERN REGIONAL MEDICAL CENTER |
| EMPLOYER ADDRESS1 | 11 UPPER RIVERDALE ROAD SW |
| EMPLOYER CITY | Riverdale |
| EMPLOYER STATE | GA |
| EMPLOYER POSTAL CODE | 30274 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17709092594 |
| NAICS CODE | 6221 |
| EMPLOYER POC LAST NAME | Dupre |
| EMPLOYER POC FIRST NAME | Charlotte |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS 1 | 11 UPPER RIVERDALE ROAD SW |
| EMPLOYER POC CITY | Riverdale |
| EMPLOYER POC STATE | GA |
| EMPLOYER POC POSTAL CODE | 30274 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17709092594 |
| EMPLOYER POC EMAIL | CDUPRE@PRIMEHEALTHCARE.COM |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Chary |
| AGENT ATTORNEY FIRST NAME | Siddharth |
| AGENT ATTORNEY MIDDLE NAME | S |
| AGENT ATTORNEY ADDRESS1 | 175 Kent Ave. |
| AGENT ATTORNEY ADDRESS2 | 416 |
| AGENT ATTORNEY CITY | Brooklyn |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 11249 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12129608365 |
| AGENT ATTORNEY EMAIL ADDRESS | sid@charylaw.com |
| LAWFIRM NAME BUSINESS NAME | Chary Law P.C. |
|
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 11 UPPER RIVERDALE ROAD SW |
| LCA CASE WORKLOC1 CITY | Riverdale |
| WORKSITE COUNTY | CLAYTON |
| LCA CASE WORKLOC1 STATE | GA |
| WORKSITE POSTAL CODE | 30274 |
| LCA CASE WAGE RATE FROM | 180000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 100422 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| 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 Employment |
