1. Authorisation Number

:

DE_RP_01_WDA_2019_54.1/GDP/111-011

2. Name of Authorisation Holder

:

Partner Pharma Logistik PPL-GmbH

3. Address(es) of Site(s)

:

St. Elisabeth-Str. 3, Koblenz, 56073, Germany 

4. Legally registered address of Authorisation Holder

:

St. Elisabeth-Str. 3, Koblenz, 56073, 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

:

2019-05-07

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

Name and address of the site: Partner Pharma Logistik PPL-GmbH

, St. Elisabeth-Str. 3, Koblenz, 56073, Germany   

Any restrictions or clarifying remarks (for all users):  ---------------------------------------------------------------------------------------------------
in English:
Procurement and supply is carried out exclusively by the company listed on Annex 2

---------------------------------------------------------------------------------------------------
in National Language:
Beschaffung und Lieferung erfolgt ausschließlich durch den in Anlage 2 genannten Betrieb.

*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_RP_01_WDA_2019_54.1/GDP/111-011

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