1. Authorisation Number

:

1574 H

2. Name of Authorisation Holder

:

Pharma Base

(ORG-100015901 / LOC-100024633)

2.a. Alternative name of authorisation holder (optional)

:

Pharma Base N.V.

3. Address(es) of Site(s)

:

Seinhuisstraat 7 Bus 1, Genk, 3600, Belgium 

3.a. Additional details on units inspected of site(s) address(es) (optional) (All authorised sites should be listed if not covered by separate authorisations)

:

Bus 1-2 

4. Legally registered address of Authorisation Holder

:

Seinhuisstraat 7 Bus 1, Genk, Limburg, 3600

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

:

2026-03-23

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

Name and address of the site: Pharma Base N.V.

(ORG-100015901 / LOC-100024633)

, Seinhuisstraat 7 Bus 1, Genk, 3600, Belgium   

Additional details on units inspected of site(s) address(es) (optional) (All authorised sites should be listed if not covered by separate authorisations): Bus 1-2

Human medicinal products

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

Reason for Withdrawing:

due to inspector note

Union Format for a Wholesale Distribution Authorisation

1574 H

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