| LCA CASE NUMBER | I-200-21099-211912 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-09 |
| DECISION DATE | 2021-04-16 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Medical Resident (Family Medicine) |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-06-20 |
| END DATE | 2024-06-19 |
| 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 | Wellspan Good Samaritan Hospital |
| TRADE NAME DBA | Wellspan Health |
| EMPLOYER ADDRESS1 | 252 S. 4th Street and Walnut Street |
| EMPLOYER CITY | Lebanon |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 17042 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17172707500 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Emrhein |
| EMPLOYER POC FIRST NAME | David |
| EMPLOYER POC MIDDLE NAME | J |
| EMPLOYER POC JOB TITLE | Administrator Director/Designated Institutional Official |
| EMPLOYER POC ADDRESS 1 | 1001 South George Street |
| EMPLOYER POC CITY | York |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 17403 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17178512967 |
| EMPLOYER POC EMAIL | demrhein@wellspan.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Ruiz-Steele |
| AGENT ATTORNEY FIRST NAME | Silas |
| AGENT ATTORNEY MIDDLE NAME | M |
| AGENT ATTORNEY ADDRESS1 | 100 East Market Street |
| AGENT ATTORNEY CITY | York |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 17401 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17178468888 |
| AGENT ATTORNEY EMAIL ADDRESS | sruizsteele@barley.com |
| LAWFIRM NAME BUSINESS NAME | Barley Snyder LLP |
|
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | Supreme |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 252 S. 4th Street |
| LCA CASE WORKLOC1 CITY | Lebanon |
| WORKSITE COUNTY | LEBANON |
| LCA CASE WORKLOC1 STATE | PA |
| WORKSITE POSTAL CODE | 17042 |
| LCA CASE WAGE RATE FROM | 62524 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 55203 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| 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 |
