| CASE NUMBER | I-200-24054-744664 |
| CASE STATUS | Certified |
| RECEIVED DATE | 2/23/2024 |
| DECISION DATE | 3/1/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1216.00 |
| SOC TITLE | General Internal Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/3/2024 |
| END DATE | 7/2/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Eastern Maine Medical Center |
| TRADE NAME DBA | Northern Light Eastern Maine Medical Center |
| EMPLOYER ADDRESS1 | 489 State Street |
| EMPLOYER ADDRESS2 | N/A |
| EMPLOYER CITY | Bangor |
| EMPLOYER STATE | ME |
| EMPLOYER POSTAL CODE | 4401 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12079739801 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Randlett |
| EMPLOYER POC FIRST NAME | Megan |
| EMPLOYER POC MIDDLE NAME | N/A |
| EMPLOYER POC JOB TITLE | VP & Deputy General Counsel |
| EMPLOYER POC ADDRESS1 | 489 State Street |
| EMPLOYER POC ADDRESS2 | N/A |
| EMPLOYER POC CITY | Bangor |
| EMPLOYER POC STATE | ME |
| EMPLOYER POC POSTAL CODE | 4401 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12079739801 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | mrandlett@northernlight.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Murray |
| AGENT ATTORNEY FIRST NAME | Michael |
| AGENT ATTORNEY MIDDLE NAME | J |
| AGENT ATTORNEY ADDRESS1 | 48 Free Street |
| AGENT ATTORNEY ADDRESS2 | Suite 300 |
| AGENT ATTORNEY CITY | Bangor |
| AGENT ATTORNEY STATE | ME |
| AGENT ATTORNEY POSTAL CODE | 4401 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12076137331 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | michael@fordmurraylaw.com |
| LAWFIRM NAME BUSINESS NAME | FordMurray |
| STATE OF HIGHEST COURT | ME |
| NAME OF HIGHEST STATE COURT | Supreme Judicial Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 489 State Street |
| WORKSITE ADDRESS2 | N/A |
| WORKSITE CITY | Bangor |
| WORKSITE COUNTY | BANGOR CITY |
| WORKSITE STATE | ME |
| WORKSITE POSTAL CODE | 4401 |
| WAGE RATE OF PAY FROM | 210000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $87,651.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 3 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Murray |
| PREPARER FIRST NAME | Michael |
| PREPARER MIDDLE INITIAL | J |
| PREPARER BUSINESS NAME | FordMurray |
| PREPARER EMAIL | michael@fordmurraylaw.com |
| BEGIN DATE CONVERTED | 2024-03-07 |
