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RTF Template

National Institute of Pharmacy and Nutrition

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	OGYÉI/28784-11/2017
2. Name of Authorisation Holder	:	Up Farma Szolgáltató és Kereskedelmi Korlátolt Felelősségű Társaság
3. Address(es) of Site(s)	:	Kiss Ernő utca 1-3. 73312/3 hrsz. (P+P Kereskedő és Szolgáltatóház), 313/A helyiség, Budapest, 1046, Hungary

4. Legally registered address of Authorisation Holder	:	Júlia utca 1. I. em. 4., Budapest, 1026, Hungary
5. Scope of authorisation (complete for each site under 4)	:	ANNEX 1
6. Legal basis of authorisation	:
7. Name of responsible officer of the competent authority of the member state granting the wholesaling authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2017-12-01
10. Annexes attached	:	Annex 1 Scope of wholesale distribution authorisation Annex 2 (Optional) Address(es) of contract wholesale distribution sites and their authorisation number Annex 3 (Optional) Name(s) of responsible person(s) Annex 4 (Optional) Date of Inspection on which authorisation was granted Annex 5 (Optional) Additional provisions based on national requirements

ANNEX 1

SCOPE OF WHOLESALE DISTRIBUTION AUTHORISATION

Name and address of the site: Up Farma Szolgáltató és Kereskedelmi Korlátolt Felelősségű Társaság

, Kiss Ernő utca 1-3. 73312/3 hrsz. (P+P Kereskedő és Szolgáltatóház), 313/A helyiség, Budapest, 1046, Hungary

1. MEDICINAL PRODUCTS

1.1. with a Marketing Authorisation in EEA country(s)

1.2. without a Marketing Authorisation in the EEA and intended for EEA market

1.3. without a Marketing Authorisation in the EEA and intended for exportation

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

2.1. Procurement

2.2. Holding

2.3. Supply

2.4. Export

Any restrictions or clarifying remarks (for all users): Authorised Wholesale Distribution Operation
2.2 Holding:
2.2.1 Room temperature (2-25°C)
2.2.2 Cool temperature (8-15°C)

Additional provisions based on national requirements

Name(s) of responsible person(s) diploma No is:
Dr. Kissné Dr. Bodolai Mária 13/1978 (pharmacist)

*Art 5 of Directive 2001/83/EC or Art 83 of Regulation EC/726/2004

**Without prejudice to further authorisations as may be required according to national legislation

Union Format for a Wholesale Distribution Authorisation	OGYÉI/28784-11/2017
	Page 1

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