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RTF Template

Regierungspraesidium Freiburg

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	DE_BW_04_WDA_2020_0005
2. Name of Authorisation Holder	:	Sanacorp Pharmahandel GmbH
3. Address(es) of Site(s)	:	Alemannenstraße 10, Tuttlingen, 78532, Germany Hanns-Martin-Schleyerstraße 14, Offenburg, 77656, Germany

4. Legally registered address of Authorisation Holder	:	Semmelweisstraße 4, Planegg, 82152, 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	:	2020-12-03
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: Sanacorp Pharmahandel GmbH Niederlassung Tuttlingen

, Alemannenstraße 10, Tuttlingen, 78532, 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

3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

3.1.1. Narcotic or psychotropic products

3.1.2. Medicinal products derived from blood

3.1.3. Immunological medicinal products

3.2. Medicinal gases

3.3. Cold chain products(requiring low temperature handling)

Name and address of the site: Sanacorp Pharmahandel GmbH Niederlassung Offenburg

, Hanns-Martin-Schleyerstraße 14, Offenburg, 77656, Germany