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RTF Template

Department of Occupational Health and Safety, Customer Protection and Health

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	DE_BB_01_WDA_2020/ G3 - 5423/ PCI/01/07.05.2020
2. Name of Authorisation Holder	:	PCI Pharma Services Germany GmbH
3. Address(es) of Site(s)	:	Am Wall 5, Grossbeeren, Brandenburg, 14979, Germany

4. Legally registered address of Authorisation Holder	:	Am Wall 5, Grossbeeren, Brandenburg, 14979, 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	:	2020-05-07
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

ANNEX 1

SCOPE OF WHOLESALE DISTRIBUTION AUTHORISATION

Name and address of the site: PCI Pharma Services Germany GmbH

, Am Wall 5, Grossbeeren, Brandenburg, 14979, 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

2.4. Export

3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

3.1.3. Immunological medicinal products

3.3. Cold chain products(requiring low temperature handling)

Any restrictions or clarifying remarks (for all users): The wholesale activity is carried out in the premises in accordance with the present floor plans of 29.01.2019.

Die Großhandelstätigkeit wird in den Räumlichkeiten gemäß den vorliegenden Grundrissplänen vom 29.01.2019 durchgeführt.

Union Format for a Wholesale Distribution Authorisation	DE_BB_01_WDA_2020/ G3 - 5423/ PCI/01/07.05.2020
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