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RTF Template


Freie und Hansestadt Hamburg, Ministry of Health and Consumer Protection

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION


1. Authorisation Number

:

DE_HH_01_WDA/517-02.13/01,0006

2. Name of Authorisation Holder

:

HCA Health Care Altona Pharma GmbH

3. Address(es) of Site(s)

:

Grosse Bergstrasse 262, Hamburg, Hamburg, 22767, Germany 




4. Legally registered address of Authorisation Holder

:

Grosse Bergstrasse 262, Hamburg, Hamburg, 22767, Germany

5. Scope of authorisation

:

ANNEX 1

6. Legal basis of authorisation

:


7. Name of responsible officer of the competent authority of the member state granting the wholesale distribution authorisation

:

Confidential, Confidential

8. Signature

:


9. Date

:

2017-01-11

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: HCA Health Care Altona Pharma GmbH

, Grosse Bergstrasse 262, Hamburg, Hamburg, 22767, Germany   




1. MEDICINAL PRODUCTS

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

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

   2.1. Procurement 

   2.2. Holding 

   2.3. Supply 


3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

   3.3. Cold chain products(requiring low temperature handling) 

















Union Format for a Wholesale Distribution Authorisation

DE_HH_01_WDA/517-02.13/01,0006


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