| LCA CASE NUMBER | I-200-21183-442622 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-07-02 |
| DECISION DATE | 2021-07-12 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician (Family Medicine) |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-19 |
| END DATE | 2024-07-18 |
| 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 | St. Joseph Hospital |
| EMPLOYER ADDRESS1 | 360 Broadway |
| EMPLOYER CITY | Bangor |
| EMPLOYER STATE | ME |
| EMPLOYER POSTAL CODE | 4401 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12079071000 |
| NAICS CODE | 62211 |
| EMPLOYER POC LAST NAME | Koffman, MD |
| EMPLOYER POC FIRST NAME | David |
| EMPLOYER POC MIDDLE NAME | J. |
| EMPLOYER POC JOB TITLE | Vice President Medical Affairs |
| EMPLOYER POC ADDRESS1 | 360 Broadway |
| EMPLOYER POC CITY | Bangor |
| EMPLOYER POC STATE | ME |
| EMPLOYER POC POSTAL CODE | 4401 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12079071300 |
| EMPLOYER POC EMAIL | Zelinda.Pullen@sjhhealth.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Raynes |
| AGENT ATTORNEY FIRST NAME | Matthew |
| AGENT ATTORNEY MIDDLE NAME | S. |
| AGENT ATTORNEY ADDRESS1 | PO Box 1210 |
| AGENT ATTORNEY CITY | Bangor |
| AGENT ATTORNEY STATE | ME |
| AGENT ATTORNEY POSTAL CODE | 04402-1210 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12079470111 |
| AGENT ATTORNEY EMAIL ADDRESS | mraynes@eatonpeabody.com |
| LAWFIRM NAME BUSINESS NAME | Eaton Peabody |
| STATE OF HIGHEST COURT | ME |
|
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 900 Broadway |
| LCA CASE WORKLOC1 CITY | Bangor |
| WORKSITE COUNTY | BANGOR CITY |
| LCA CASE WORKLOC1 STATE | ME |
| WORKSITE POSTAL CODE | 4401 |
| LCA CASE WAGE RATE FROM | 215000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 162843 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
