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RTF Template

Apothekerkammer Niedersachsen

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Human medicinal products

1. Authorisation Number	:	DE_NI_05_WDA_2023_0058
2. Name of Authorisation Holder	:	Apotheke am Krankenhaus Norden Inh. Thomas Tennstedt e.K. (ORG-100048699 / LOC-100080716)
3. Address(es) of Site(s)	:	Juister Strasse 8/9, Norden, Lower Saxony, 26506, Germany

4. Legally registered address of Authorisation Holder	:	Juister Strasse 8/9, Norden, Lower Saxony, 26506
4.a. Additional details on units inspected of registrant's legal address (optional)	:	Permission was granted for the wholesale of the Apotheke am Krankenhaus, Juister Straße 8-9, 26506, Norden.
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
7. Name of responsible officer of the competent authority of the member state granting the wholesaling authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2023-07-04
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: Apotheke am Krankenhaus Norden Inh. Thomas Tennstedt e.K.

(ORG-100048699 / LOC-100080716)

, Juister Strasse 8/9, Norden, Lower Saxony, 26506, Germany

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

Any restrictions or clarifying remarks (for all users): The permit is valid for the operating space shown as of September 14, 2022 (as shown on the space plan).

Die Genehmigung gilt für die ab dem 14. September 2022 ausgewiesene Betriebsfläche (wie auf dem Raumplan dargestellt).

*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	DE_NI_05_WDA_2023_0058
	Page 1

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