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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	:	79/ADG/MUV/OL/2011
2. Name of Authorisation Holder	:	Vipfarma Logistica Farmaceutica Lda. (ORG-100037435 / LOC-100059116)
3. Address(es) of Site(s)	:	Rua Das Industrias 18, Venda Do Pinheiro, 2665-628, Portugal

4. Legally registered address of Authorisation Holder	:	Rua Das Industrias 18, Venda Do Pinheiro, 2665-628
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	:	2023-01-17
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: Vipfarma Logistica Farmaceutica Lda.

(ORG-100037435 / LOC-100059116)

, Rua Das Industrias 18, Venda Do Pinheiro, 2665-628, 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) Non-biological VMP (room temperature) Immunological and premix for medicated feed

Union Format for a Wholesale Distribution Authorisation	79/ADG/MUV/OL/2011
	Page 1

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