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RTF Template


Bezirksregierung Düsseldorf

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION


1. Authorisation Number

:

DE_NW_03_WDA_2020_0030/ 24.05.05.01-Medic

2. Name of Authorisation Holder

:

MEDIC GmbH

3. Address(es) of Site(s)

:

Am Schornacker 30, Wesel, 46485, Germany 




4. Legally registered address of Authorisation Holder

:

Am Schornacker 30, Wesel, 46485, Germany

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

:

2020-10-19

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: MEDIC GmbH

, Am Schornacker 30, Wesel, 46485, Germany   




1. MEDICINAL PRODUCTS

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


2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

   2.1. Procurement 

   2.3. Supply 



Any restrictions or clarifying remarks (for all users):  The scope of this authorisation is granted with the restriction, that no storage of medicinal products is allowed in the site mentioned above. The storage is carried out by the company mentioned in Annex 2.

Die Erlaubnis wird mit der Einschränkung erteilt, dass keine Lagerung von Arzneimitteln in der oben genannten Betriebsstätte erlaubt ist. Die Lagerung erfolgt durch den in der Anlage 2 genannten Betrieb.


Annex 2/ Anlage 2:
Megro Gesellschaft vereinigter
medizinitechnischer Großhändler mbH & Co. KG
Am Schornacker 30
46485 Wesel



*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

DE_NW_03_WDA_2020_0030/ 24.05.05.01-Medic


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