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RTF Template

Competent Regional Authority. Secretaría General de la Consejería de Sanidad. Comunidad Autónoma de Galicia. España.

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	C-22-A
2. Name of Authorisation Holder	:	COFANO FARMACEUTICA DEL NOROESTE, SOCIEDAD COOPERATIVA GALLEGA
3. Address(es) of Site(s)	:	Polígono Empresarial Pedrapartida parcelas 12/14, naves 3 y 4, Coirós, Coruña, 15316, Spain

4. Legally registered address of Authorisation Holder	:	Camiño do Caramuxo, 13, Vigo, Pontevedra, 36213, Spain
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	:	2019-07-29
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: COFANO FARMACEUTICA DEL NOROESTE SOCIEDAD COOPERATIVA GALLEGA

, Polígono Empresarial Pedrapartida parcelas 12/14, naves 3 y 4, Coirós, Coruña, 15316, Spain

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

3.1.1. 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: Medicamentos veterinariosMedicamentos de alta actividad

*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	C-22-A
	Page 1

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