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RTF Template

Landesamt Fuer Gesundheit Und Soziales

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Human medicinal products

1. Authorisation Number	:	5373/2-heyl/4
2. Name of Authorisation Holder	:	H e y l Chemisch-pharmazeutische Fabrik GmbH & Co. KG (ORG-100003254 / LOC-100009787)
3. Address(es) of Site(s)	:	Kurfuerstendamm 178-179, Wilmersdorf, Berlin, 10707, Germany

4. Legally registered address of Authorisation Holder	:	Kurfuerstendamm 178-179, Wilmersdorf, Berlin, 10707, Germany
5. Scope of authorisation	:	ANNEX 1
6. Legal basis of authorisation	:	§ 52a Arzneimittelgesetz
7. Name of responsible officer of the competent authority of the member state granting the wholesale distribution authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2018-04-23
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: H e y l Chemisch-pharmazeutische Fabrik GmbH & Co. KG

(ORG-100003254 / LOC-100009787)

, Kurfuerstendamm 178-179, Wilmersdorf, Berlin, 10707, Germany

Human medicinal products

1. MEDICINAL PRODUCTS

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

1.3. without a Marketing Authorisation or registration in the EEA and intended for exportation

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

2.1. Procurement

2.3. Supply

2.4. Export

Any restrictions or clarifying remarks (for all users): There is no physical handling of medicinal products on the site.
The authorisation is based on the floor plan from 2018/04/23

In der Betriebsstätte erfolgt kein physischer Umgang mit Arzneimitteln.
Die Erlaubnis basiert auf dem Grundrissplan vom 23.04.2018

Union Format for a Wholesale Distribution Authorisation	5373/2-heyl/4
	Page 1

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