Regierungspraesidium Tuebingen, Leitstelle Arzneimittelueberwachung Baden-Wuerttemberg
UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION
1. Authorisation Number
:
GHE_be imaging_001_21
2. Name of Authorisation Holder
be imaging GmbH
3. Address(es) of Site(s)
Dr. Rudolf-Eberle-Str. 8-10, Baden-Baden, Baden-Wuerttemberg, 76534, Germany
4. Legally registered address of Authorisation Holder
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
2021-02-08
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
SCOPE OF WHOLESALE DISTRIBUTION AUTHORISATION
Name and address of the site: be imaging GmbH
, Dr. Rudolf-Eberle-Str. 8-10, Baden-Baden, Baden-Wuerttemberg, 76534, Germany
1.1. with a Marketing Authorisation in EEA country(s)
1.3. without a Marketing Authorisation in the EEA and intended for exportation
2.1. Procurement
2.2. Holding
2.3. Supply
2.4. Export
Union Format for a Wholesale Distribution Authorisation
Page 1
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