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RTF Template

Directorate General For Food And Veterinary

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Veterinary medicinal products

1. Authorisation Number	:	86/ADG/MUV/2012 DGV
2. Name of Authorisation Holder	:	Alliance Healthcare S.A. (ORG-100009467 / LOC-100017722)
3. Address(es) of Site(s)	:	Caminho Cerro Do Galo No 18, Almancil, Loule, 8135-028, Portugal

4. Legally registered address of Authorisation Holder	:	Rua Engenheiro Ferreira Dias 738, Porto, 4149-014
5. Scope of authorisation	:	ANNEX 1
6. Legal basis of authorisation	:	Art. 99 of Regulation (EU) 2019/6
7. Name of responsible officer of the competent authority of the member state granting the wholesale distribution authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2022-11-23
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: Alliance Healthcare S.A.

(ORG-100009467 / LOC-100064098)

, Caminho Cerro Do Galo No 18, Almancil, Loule, 8135-028, Portugal

Veterinary 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

2.4. Export

3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

3.2. Products requiring low temperature handling

3.2.1. Temperatures between 2 to 8 °C

3.3. Other products: (please specify here or make a reference to Annex 5) VMP Room tempertaure

Union Format for a Wholesale Distribution Authorisation	86/ADG/MUV/2012 DGV
	Page 1

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