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RTF Template

Department of drug and pharmacy supervision

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	DE_ST_01_WDA_2018_005
2. Name of Authorisation Holder	:	PraxiMed Halle GmbH
3. Address(es) of Site(s)	:	Wilhelm-von-Klewiz-Straße 11, Halle (Saale), 06132, Germany

4. Legally registered address of Authorisation Holder	:	Wilhelm-von-Klewiz-Straße 11, Halle (Saale), 06132, 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	:	2018-04-12
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: PraxiMed Halle GmbH

, Wilhelm-von-Klewiz-Straße 11, Halle (Saale), 06132, 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

3.2. Medicinal gases

Any restrictions or clarifying remarks (for all users): Wholesale is carried out in the premises according to the present site plan of 27.04.2005.
Only skin and hand disinfectants, infusion solutions and medical oxygen in bottles are traded. The delivery of these products is only to doctors and other consumers and partly by drop shipement.

Der Großhandel wird in den Räumen gemäß dem vorliegenden Lageplan vom 27.04.2005 durchgeführt.
Es werden ausschließlich Haut- und Händedesinfektionsmittel, Infusions-lösungen sowie medizinischer Sauerstoff in Flaschen gehandelt. Die Abgabe der genannten Produkte erfolgt nur an Ärzte und andere Verbraucher und teilweise im Streckengeschäft.

Union Format for a Wholesale Distribution Authorisation	DE_ST_01_WDA_2018_005
	Page 1

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