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RTF Template

Landesamt für soziale Dienste Schleswig-Holstein

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	DE_SH_01_WDA_2018_0034
2. Name of Authorisation Holder	:	Jonas Medizintechnik, Inhaber Carsten Jonas
3. Address(es) of Site(s)	:	Kirchhofallee 18, Gettorf, 24214, Germany Kieler Straße 41, Schwentinental, 24223, Germany

4. Legally registered address of Authorisation Holder	:	Kirchhofallee 18, Gettorf, 24214, 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	:	2018-12-13
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: Jonas Medizintechnik, Inhaber Carsten Jonas

, Kirchhofallee 18, Gettorf, 24214, 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): National legal basis of authorisation: Section 52a (1) German Drug Law (Arzneimittelgesetz - AMG)

To 1.1 Medicinal gases only

Name and address of the site: Jonas Medizintechnik, Inhaber Carsten Jonas

, Kieler Straße 41, Schwentinental, 24223, Germany

1. MEDICINAL PRODUCTS

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

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

2.2. Holding

3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

3.2. Medicinal gases

Any restrictions or clarifying remarks (for all users): National legal basis of authorisation: Section 52a (1) German Drug Law (Arzneimittelgesetz - AMG)

Storage of medicinal gases only.

*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_SH_01_WDA_2018_0034
	Page 1

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