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RTF Template

Regierungspraesidium Tuebingen - Referat 25: Übrige Pharmazeutische Bereiche

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	DE_BW_05_WDA_2021_0003
2. Name of Authorisation Holder	:	Bernd Nestle
3. Address(es) of Site(s)	:	Franziskusplatz 1, Friedrichshafen, 88045, Germany

4. Legally registered address of Authorisation Holder	:	Franziskusplatz 1, Friedrichshafen, 88045, 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	:	2021-10-11
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: Großhandel der Nestle-Apotheke am See

, Franziskusplatz 1, Friedrichshafen, 88045, 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

3.3. Cold chain products(requiring low temperature handling)

Any restrictions or clarifying remarks (for all users): wholesale distributor comprises the rooms in the ground floor and basement situated in the building Franziskusplatz 1 (store space 2) in 88045 Friedrichshafen und are based on the floor plans sent by letter on 17th of August 2021 (dated on 28th of June 2021).

Die Erlaubnis umfasst die Räumlichkeiten im Erd- und ersten Untergeschoss des Gebäudes Franziskusplatz 1 (Ladenfläche 2) in 88045 Friedrichshafen und basiert auf den am 17.08.2021 übersandten Grundrissplänen (Stand: 28.06.2021).

*Art 5 of Directive 2001/83/EC or Art 83 of Regulation EC/726/2004

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

Union Format for a Wholesale Distribution Authorisation	DE_BW_05_WDA_2021_0003
	Page 1

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