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RTF Template

Staatliches Gewerbeaufsichtsamt Oldenburg

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Human medicinal products

1. Authorisation Number	:	DE_NI_04_WDA_2021_0005/ 41403-16/5
2. Name of Authorisation Holder	:	B. Braun Avitum
3. Address(es) of Site(s)	:	Kattenvenner Strasse 32, Glandorf, 49219, Germany

4. Legally registered address of Authorisation Holder	:	Schwarzenberger Weg 73, Melsungen, 34212
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	:	2021-06-04
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: B.Braun Avitum AG

(ORG-100000969 / LOC-100005536)

, Kattenvenner Strasse 32, Glandorf, 49219, Germany

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

Any restrictions or clarifying remarks (for all users): To Annex5: Name and address of the external warehouse in the subcontract:
Heinrich Koch International Spedition GmbH & Co. KG
Am Tie 11, 49086 Osnabrück

Anlage 5 : Name und Anschrift des Externen Lagers im Lohnauftrag :
Heinrich Koch International Spedition GmbH & Co. KG
Am Tie 11, 49086 Osnabrück

Union Format for a Wholesale Distribution Authorisation	DE_NI_04_WDA_2021_0005/ 41403-16/5
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