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RTF Template


Bezirksregierung Köln

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION


1. Authorisation Number

:

53-2222-GH03

2. Name of Authorisation Holder

:

Pharmahandel Hafizi e.K.

3. Address(es) of Site(s)

:

Hüttenstr. 36, Bergisch Gladbach, 51469, Germany 




4. Legally registered address of Authorisation Holder

:

Hüttenstr. 36, Bergisch Gladbach, 51469, 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

:

2019-01-31

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: Pharmahandel Hafizi e.K.

, Hüttenstr. 36, Bergisch Gladbach, 51469, 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 



Any restrictions or clarifying remarks (for all users):  This WDA has been registered for datatechnical reasons by the Bezirksregierung Köln (District Government of Cologne) in EUDRA GMDP.
Issue oft he original document and competent authority is the Rheinisch-Bergischer Kreis (Rheinisch-Bergisch district) with the responsible officer Ms Anke Baier Only for technical reasons the Bezirksregierung Köln and an officer of the Bezirksregierung Köln appear in this electronic entry. Decisive is the original document.

Diese Großhandelserlaubnis ist aus datentechnischen Gründen von der Bezirksregierung Köln in EUDRA GMDP eingetragen worden.
Aussteller der Originalurkunde und zuständige Behörde ist die Stadt Köln mit der ausstellenden Mitarbeiterin Anke Baier. Lediglich aus technischen Gründen erscheint die Bezirksregierung Köln und ein Mitarbeiter der Bezirksregierung Köln in diesem elektronischen Eintrag. Maßgebend ist die Originalurkunde.



*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

53-2222-GH03


Page 1





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