| LCA CASE NUMBER | I-200-21250-567459 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-09-07 |
| DECISION DATE | 2021-09-14 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internists, General |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-09-07 |
| END DATE | 2024-09-06 |
| 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 | Health Professionals of Holmes County, Inc. |
| TRADE NAME DBA | Pomerene Hospital |
| EMPLOYER ADDRESS1 | 1261 Wooster Road |
| EMPLOYER ADDRESS2 | 981 Wooster Road |
| EMPLOYER CITY | Millersburg |
| EMPLOYER STATE | OH |
| EMPLOYER POSTAL CODE | 44654 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13306741584 |
| EMPLOYER PHONE EXT | 1753 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Justus |
| EMPLOYER POC FIRST NAME | Jason |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 1261 Wooster Road |
| EMPLOYER POC CITY | Millersburg |
| EMPLOYER POC STATE | OH |
| EMPLOYER POC POSTAL CODE | 44654 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13306741584 |
| EMPLOYER POC PHONE EXT | 1753 |
| EMPLOYER POC EMAIL | jasonj@pomerenehospital.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Dhinojwala |
| AGENT ATTORNEY FIRST NAME | Duriya |
| AGENT ATTORNEY ADDRESS1 | 75 E. Market Street |
| AGENT ATTORNEY CITY | Akron |
| AGENT ATTORNEY STATE | OH |
| AGENT ATTORNEY POSTAL CODE | 44308 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13304725729 |
| AGENT ATTORNEY EMAIL ADDRESS | ddhinojwala@icloud.com |
|
| LAWFIRM NAME BUSINESS NAME | Brennan, Manna & Diamond, LLC |
| STATE OF HIGHEST COURT | OH |
| NAME OF HIGHEST STATE COURT | OHIO SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | Transitional Care Unit |
| WORKSITE ADDRESS2 | 4748 Olde Pump Street |
| LCA CASE WORKLOC1 CITY | Walnut Creek |
| WORKSITE COUNTY | HOLMES |
| LCA CASE WORKLOC1 STATE | OH |
| WORKSITE POSTAL CODE | 44687 |
| LCA CASE WAGE RATE FROM | 102.35 |
| LCA CASE WAGE RATE TO | 175 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 102.35 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | IV |
| 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 |
| PREPARER LAST NAME | Dhinojwala |
| PREPARER FIRST NAME | Duriya |
| PREPARER BUSINESS NAME | Brennan, Manna & Diamond, LLC |
| PREPARER EMAIL | ddhinojwala@icloud.com |
