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RTF Template

State Agency Of Medicines Of Latvia

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Human medicinal products and Veterinary medicinal products

1. Authorisation Number	:	L00010
2. Name of Authorisation Holder	:	Farm Impeks SIA (ORG-100027153 / LOC-100071620)
3. Address(es) of Site(s)	:	Uriekstes Iela 3k-3, Riga, 1005, Latvia

4. Legally registered address of Authorisation Holder	:	Gaujas Iela 59, Riga, 1026
5. Scope of authorisation (complete for each site under 4)	:	ANNEX 1
6. Legal basis of authorisation	:	Art. 77(1) of Directive 2001/83/EC Art. 99 of Regulation (EU) 2019/6
7. Name of responsible officer of the competent authority of the member state granting the wholesaling authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2023-07-17
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: Farm Impeks SIA

(ORG-100027153 / LOC-100078484)

, Uriekstes Iela 3k-3, Riga, 1005, Latvia

Human medicinal products

Veterinary medicinal products

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

2.5. Other activities(s): distribution of medicinal products of contract wholesales

3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

3.1.1. Narcotic or psychotropic products

3.1.2. Medicinal products derived from blood

3.1.3. Immunological medicinal products

3.3. Cold chain products(requiring low temperature handling)

3.4. Other products: 3.4.1.veterinary medicinal products

Any restrictions or clarifying remarks (for all users): 3.1.1. narcotic and equivalent thereto psychotropic medicinal products or substances or psychotropic medicinal products or substances:3.1.1.1. psychotropic medicinal products, 3.1.1.3. narcotic and equivalent thereto psychotropic medicinal products

*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	L00010
	Page 1

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