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RTF Template


Chief Pharmaceutical Inspectorate

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Human medicinal products


1. Authorisation Number

:

NZOH.5100.64.2020.MG.4

2. Name of Authorisation Holder

:

Messer Polska Sp. z o.o.

(ORG-100002936 / LOC-100004225)

3. Address(es) of Site(s)

:

Ul. Korytkowska 12, Turek, 62-700, Poland 




4. Legally registered address of Authorisation Holder

:

Ul. Maciejkowicka 30, Chorzow, 41-500

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

:

2020-08-31

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: Messer Polska Sp. z o.o.

(ORG-100002936 / LOC-100095149)

, Ul. Korytkowska 12, Turek, 62-700, Poland   



Human medicinal products


1. MEDICINAL PRODUCTS

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

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

   2.1. Procurement 

   2.2. Holding 

   2.3. Supply 


3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

   3.3. Other products: (please specify here or make a reference to Annex 5) Gazy medyczne

















Union Format for a Wholesale Distribution Authorisation

NZOH.5100.64.2020.MG.4


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