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RTF Template

State Agency Of Medicines

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Human medicinal products

1. Authorisation Number	:	L00132
2. Name of Authorisation Holder	:	FaroAktivs SIA (ORG-100036845 / LOC-100058213)
3. Address(es) of Site(s)	:	Ziemeļu Iela 4, Marupes Novads, 1053, Latvia

4. Legally registered address of Authorisation Holder	:	Dammes Iela 34-5, Riga, 1069
5. Scope of authorisation	:	ANNEX 1
6. Legal basis of authorisation	:	Art. 77(1) of Directive 2001/83/EC
7. Name of responsible officer of the competent authority of the member state granting the wholesale distribution authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2026-04-01
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: FaroAktivs SIA

(ORG-100036845 / LOC-100065903)

, Ziemeļu Iela 4, Marupes Novads, 1053, Latvia

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

3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

3.1. Narcotic or psychotropic products**

Any restrictions or clarifying remarks (for all users): 3.1. narcotic or psychotropic products: 3.1.1 psychotropic medicinal products;
holding of medicinal products in Ziemeļu street 4, Lidosta "Rīga", Mārupes pagasts, Mārupes novads, LV-1053, Latvia (sites of contract wholesale distribution SIA "ASTRA LOGISTIC Ltd.", number of authorisation Nr. L00051).

**Without prejudice to further authorisations as may be required according to national legislation.

Union Format for a Wholesale Distribution Authorisation	L00132
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