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RTF Template

Landesdirektion Sachsen

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

1. Authorisation Number	:	DE_SN_01/L24.2-5117/164
2. Name of Authorisation Holder	:	Ulrich Tuchscherer
3. Address(es) of Site(s)	:	Am Brückenberg 12, Schwarzenberg, 08340, Germany

4. Legally registered address of Authorisation Holder	:	Am Brückenberg 12, Schwarzenberg, 08340, Germany
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	:	2018-09-14
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: Medizinisches Fachgeschäft Ulrich Tuchscherer

, Am Brückenberg 12, Schwarzenberg, 08340, Germany

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

2.4. Export

3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

3.2. Medicinal gases

Any restrictions or clarifying remarks (for all users): This authorisation is limited to infusion solutions intended for the replacement or the correction of body fluid, disinfectants, and medicinal gases. It does not cover the authorisation for wholesale distribution of products which should be stored under "cool", "cold" or "freezer" conditions.

Diese Erlaubnis gilt nur für den Großhandel mit Infusionslösungen, die zum Ersatz oder zur Korrektur von Körperflüssigkeit bestimmt sind, Desinfektionsmitteln und medizinischen Gasen. Sie umfasst nicht die Erlaubnis zum Großhandel mit kühl oder tiefgekühlt zu lagernden Arzneimitteln.

*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_SN_01/L24.2-5117/164
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