| CASE NUMBER | I-200-24331-502821 |
| CASE STATUS | Certified |
| RECEIVED DATE | 11/26/2024 |
| DECISION DATE | 12/4/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Hospitalist Physician |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/15/2025 |
| END DATE | 1/14/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | CAPSTONE HEALTH SERVICES FOUNDATION |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 850 PETER BRYCE BOULEVARD |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | TUSCALOOSA |
| EMPLOYER STATE | AL |
| EMPLOYER POSTAL CODE | 35401 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12053481288 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Arendale |
| EMPLOYER POC FIRST NAME | Allison |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief Finance and Operations Officer |
| EMPLOYER POC ADDRESS1 | 850 PETER BRYCE BOULEVARD |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | TUSCALOOSA |
| EMPLOYER POC STATE | AL |
| EMPLOYER POC POSTAL CODE | 35401 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12053481288 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | AARENDALE@UA.EDU |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Tedrow |
| AGENT ATTORNEY FIRST NAME | Klari |
| AGENT ATTORNEY MIDDLE NAME | B |
| AGENT ATTORNEY ADDRESS1 | 1976 Gadsden Hwy |
| AGENT ATTORNEY ADDRESS2 | Suite 200 |
| AGENT ATTORNEY CITY | Birmingham |
| AGENT ATTORNEY STATE | AL |
| AGENT ATTORNEY POSTAL CODE | 35235 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12058718084 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | daizy@usimmigrant.net |
| LAWFIRM NAME BUSINESS NAME | Klari B. Tedrow, LLC |
| STATE OF HIGHEST COURT | AL |
| NAME OF HIGHEST STATE COURT | SUPREME COURT OF ALABAMA |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 809 University Blvd E |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Tuscaloosa |
| WORKSITE COUNTY | TUSCALOOSA |
| WORKSITE STATE | AL |
| WORKSITE POSTAL CODE | 35401 |
| WAGE RATE OF PAY FROM | $300,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $127,691.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| 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 | Tedrow |
| PREPARER FIRST NAME | Klari |
| PREPARER MIDDLE INITIAL | B |
| PREPARER BUSINESS NAME | Klari B. Tedrow, LLC |
| PREPARER EMAIL | ktedrow@usimmigrant.net |
| BEGIN DATE CONVERTED | 2025-01-15 |
