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RTF Template

National Authority Of Medicines And Health Products

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Human medicinal products

1. Authorisation Number	:	A002/18/H/002/2023
2. Name of Authorisation Holder	:	Vivisol Portugal Cuidados Domiciliarios Unipessoal Lda. (ORG-100037448 / LOC-100059134)
3. Address(es) of Site(s)	:	Rua Principal N 63, Armazem B Barreira, Barreira, 3150-110, Portugal

4. Legally registered address of Authorisation Holder	:	R/c Int, Rua Dona Maria Elsa Franco Sotto Mayor 30, Condeixa-A-Nova, 3150-152
5. Scope of authorisation (complete for each site under 4)	:	ANNEX 1
6. Legal basis of authorisation	:	Art. 77(1) of Directive 2001/83/EC National legal basis of authorisation: Art. 94.º of Decree-law 176/2006, of 30th August.
7. Name of responsible officer of the competent authority of the member state granting the wholesaling authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2023-06-22
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: Vivisol Portugal Cuidados Domiciliarios Unipessoal Lda.

(ORG-100037448 / LOC-100062831)

, Rua Principal N 63, Armazem B Barreira, Barreira, 3150-110, Portugal

Human medicinal products

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

3.2. Medicinal gases

Any restrictions or clarifying remarks (for all users): WDA scope activity - Wholesale Distributor.

Complete Legal Address: Rua D. Elsa Sotto Mayor, Edifício Conimbriga, Loja 30, R/c Int. - 3150-133 Condeixa-a-Nova

*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	A002/18/H/002/2023
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