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RTF Template


Chief Pharmaceutical Inspectorate

UNION FORMAT FOR A WHOLESALE DISTRIBUTION AUTHORISATION

Human medicinal products


1. Authorisation Number

:

GIF-N-412/83/1-4/MSH/12

2. Name of Authorisation Holder

:

Logfarma Sp. z o.o.

(ORG-100036584 / LOC-100057826)

3. Address(es) of Site(s)

:

Ul. Komandosow 1/1, Modlniczka, Wielka Wies, Malopolskie, 32-085, Poland 




4. Legally registered address of Authorisation Holder

:

Ul. Komandosow 1/1, Modlniczka, Wielka Wies, Malopolskie, 32-085

5. Scope of authorisation

:

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 wholesale distribution authorisation

:

Confidential, Confidential

8. Signature

:


9. Date

:

2026-06-18

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: Logfarma Sp. z o.o.

(ORG-100036584 / LOC-100057826)

, Ul. Komandosow 1/1, Modlniczka, Wielka Wies, Malopolskie, 32-085, Poland   



Human medicinal products


1. MEDICINAL PRODUCTS

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

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


2. AUTHORISED WHOLESALE DISTRIBUTION OPERATIONS

   2.1. Procurement 

   2.2. Holding 

   2.3. Supply 

   2.4. Export 


3. MEDICINAL PRODUCTS WITH ADDITIONAL REQUIREMENTS

   3.1. Narcotic or psychotropic products** 

   3.2. Products requiring low temperature handling 

     3.2.1. Temperatures between 2 to 8 °C 

     3.2.2. Other temperatures: (please specify) temperatury od 8° C do 15° C

   3.3. Other products: (please specify here or make a reference to Annex 5) immunologiczne produkty lecznicze, cytostatyczne produkty lecznicze





*Art. 5 of Directive 2001/83/EC, Art. 83 of Regulation (EC) 726/2004 and Art. 110 of Regulation 2019/6.

**Without prejudice to further authorisations as may be required according to national legislation.













Union Format for a Wholesale Distribution Authorisation

GIF-N-412/83/1-4/MSH/12


Page 1





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