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RTF Template

Bezirksregierung Köln

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	DE_NW_04_WDA_2019-0158
2. Name of Authorisation Holder	:	Uro-GmbH Nordrhein
3. Address(es) of Site(s)	:	Hohenstaufenring 48-54, Köln, 50674, Germany

4. Legally registered address of Authorisation Holder	:	Hohenstaufenring 48-54, Köln, 50674, 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	:	2019-05-29
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: Uro-GmbH Nordrhein

, Hohenstaufenring 48-54, Köln, 50674, 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 permission is limited to the trade in contrast media.

Die Erlaubnis ist beschränkt auf den Handel mit Kontrastmitteln.

Union Format for a Wholesale Distribution Authorisation	DE_NW_04_WDA_2019-0158
	Page 1

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