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RTF Template

State Medicines Control Agency under the Ministry of Health of the Republic of Lithuania

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	0878
2. Name of Authorisation Holder	:	MB Globex AAA
3. Address(es) of Site(s)	:	Karaliaus Mindaugo pr. 68-3, Kauno m. sav., Kauno m., LT-44351, Lithuania

4. Legally registered address of Authorisation Holder	:	K. Donelaičio g. 62-1, Kauno m. sav., Kauno m.,, LT-44248, Lithuania
5. Scope of authorisation (complete for each site under 4)	:	ANNEX 1
6. Legal basis of authorisation	:
7. Name of responsible officer of the competent authority of the member state granting the wholesaling authorisation	:	Confidential, Confidential
8. Signature	:
9. Date	:	2014-09-01
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: MB Globex AAA

, Karaliaus Mindaugo pr. 68-3, Kauno m. sav., Kauno m., LT-44351, Lithuania

1. MEDICINAL PRODUCTS

1.1. with a Marketing Authorisation in EEA country(s)

1.2. without a Marketing Authorisation in the EEA and intended for EEA market

1.3. without a Marketing Authorisation in the EEA and intended for exportation

2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

2.1. Procurement

2.3. Supply

2.4. Export

3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

3.1.1. Narcotic or psychotropic products

3.3. Cold chain products(requiring low temperature handling)

3.4. Other products: Herbal, homeopatic medicinal products Augaliniai, homeopatiniai preparatai

Any restrictions or clarifying remarks (for all users): Agreement on warehousing and distribution of 1 January 2018 with UAB „ABC Farma", Ryternos g. 5, Biruliškių k., Karmėlavos sen., Kauno r. sav. ,Lithuania (Wholesale Distribution Authorisation No. 0822). Wholesale distribution operations performed according to the agreement: reception of medicinal products, holding (warehousing), collection, transportation.

2018-01-01 sandėliavimo ir distribucijos sutartis su UAB „ABC Farma", Ryternos g. 5, Biruliškių k., Karmėlavos sen., Kauno r. sav. (Didmeninio platinimo licencija Nr. 0822). Pagal sutartį vykdomi didmeninio platinimo veiksmai : vaistinių preparatų priėmimas, laikymas (saugojimas), surinkimas, transportavimas.

*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	0878
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