Указ Главы Республики Коми от 24.04.2014 № 44

|      |                                |                                       | применения                                                           |
|      |                                |                                       |      ___ *  Хранение   лекарственных  препаратов  для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |      ___ *   Перевозка   лекарственных  средств   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |      ___ *  Перевозка  лекарственных  препаратов  для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |      ___ *  Розничная   торговля   лекарственными  препаратами   для |
|      |                                |                                       | медицинского применения                                              |
|      |                                |                                       |      ___ *   Отпуск   лекарственных  препаратов   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |      ___ * Изготовление  лекарственных  препаратов для  медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |                                                                      |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|      | 2.3. Аптека производственная с |                                       |      __ *  Хранение   лекарственных   препаратов  для   медицинского |
|      | правом изготовления            |                                       | применения                                                           |
|      | асептических     лекарственных |                                       |      __ *   Розничная   торговля  лекарственными   препаратами   для |
|      | препаратов                     |                                       | медицинского применения                                              |
|      |                                |                                       |      __ *   Отпуск   лекарственных   препаратов   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |                                                                      |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|      | 2.4. Аптечный пункт            |                                       |      __ *  Хранение   лекарственных   препаратов  для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |      __ *   Розничная   торговля  лекарственными   препаратами   для |
|      |                                |                                       | медицинского применения                                              |
|      |                                |                                       |      __ *   Отпуск   лекарственных   препаратов   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |                                                                      |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|      | 2.5. Аптечный киоск            |                                       |      __ *  Хранение   лекарственных   препаратов  для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |      __ *   Розничная   торговля  лекарственными   препаратами   для |
|      |                                |                                       | медицинского применения                                              |
|      |                                |                                       |      __ *   Отпуск   лекарственных   препаратов   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |                                                                      |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|      |                                     3. Обособленные подразделения медицинских организаций, расположенные                                      |
|      |                                      в сельских поселениях, в которых отсутствуют аптечные организации:                                       |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|      | 3.1. Центр  (отделение)  общей |                                       |      __ *  Хранение   лекарственных   препаратов  для   медицинского |
|      | врачебной (семейной) практики  |                                       | применения                                                           |
|      |                                |                                       |      __ *   Розничная   торговля  лекарственными   препаратами   для |
|      |                                |                                       | медицинского применения                                              |
|      |                                |                                       |      __ *   Отпуск   лекарственных   препаратов   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |                                                                      |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|      | 3.2. Амбулатория               |                                       |      __ *  Хранение   лекарственных   препаратов  для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |      __ *   Розничная   торговля  лекарственными   препаратами   для |
|      |                                |                                       | медицинского применения                                              |
|      |                                |                                       |      __ *   Отпуск   лекарственных   препаратов   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |                                                                      |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|      | 3.3. Фельдшерский пункт        |                                       |      __ *  Хранение   лекарственных   препаратов  для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |      __ *   Розничная   торговля  лекарственными   препаратами   для |
|      |                                |                                       | медицинского применения                                              |
|      |                                |                                       |      __ *   Отпуск   лекарственных   препаратов   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |                                                                      |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|      | 3.4. Фельдшерско -             |                                       |      __ *  Хранение   лекарственных   препаратов  для   медицинского |
|      | акушерский пункт               |                                       | применения                                                           |
|      |                                |                                       |      __ *   Розничная   торговля  лекарственными   препаратами   для |
|      |                                |                                       | медицинского применения                                              |
|      |                                |                                       |      __ *   Отпуск   лекарственных   препаратов   для   медицинского |
|      |                                |                                       | применения                                                           |
|      |                                |                                       |                                                                      |
+------+--------------------------------+---------------------------------------+----------------------------------------------------------------------+
|  7.  | Государственный                |                                                                                                              |
|      | регистрационный номер записи о |                                                                                                              |
|      | государственной    регистрации |                                                                                                              |
|      | (для           индивидуального |                                                                                                              |
|      | предпринимателя)/              |                                                                                                              |
|      | Государственный                |                                                                                                              |
|      | регистрационный номер записи о |                                                                                                              |
|      | создании   (для   юридического |                                                                                                              |
|      | лица)                          |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
|  8.  | Данные документа,              | Выдан: ______________________________________________                                                        |
|      | подтверждающего факт  внесения |                                          (орган, выдавший документ)                                          |
|      | сведений о юридическом лице  в | Дата выдачи:__________________________________                                                               |
|      | Единый государственный  реестр | Бланк: серия ____________N ______________________                                                            |
|      | юридических лиц / сведений  об | Адрес места нахождения органа, осуществившего государственную регистрацию: ______________________________    |
|      | индивидуальном предпринимателе | ____________________________________________________________________________________________________________ |
|      | в    Единый    государственный |                                                                                                              |
|      | реестр          индивидуальных |                                                                                                              |
|      | предпринимателей, с  указанием |                                                                                                              |
|      | адреса    места     нахождения |                                                                                                              |
|      | органа,         осуществившего |                                                                                                              |
|      | государственную регистрацию    |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
|  9.  | Идентификационный номер        |                                                                                                              |
|      | налогоплательщика              |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
| 10.  | Наименование, код              | ______________________________________________________                                                       |
|      | подразделения, адрес налоговой | Код подразделения: ____________________________________                                                      |
|      | инспекции     (с     указанием | Адрес налоговой инспекции: ____________________________                                                      |
|      | почтового индекса)             | ______________________________________________________                                                       |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
| 11.  | Данные документа о  постановке | Выдан: _______________________________________________                                                       |
|      | соискателя лицензии на учет  в |                                          (орган, выдавший документ)                                          |
|      | налоговом органе               | Дата выдачи: __________________________________________                                                      |
|      |                                | Бланк: серия ______________________ N _________________                                                      |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
| 12.  | Сведения о         документах, | Реквизиты документов:                                                                                        |
|      | подтверждающих    наличие    у |                                                                                                              |
|      | соискателя  лицензии на  праве |                                                                                                              |
|      | собственности     или     ином |                                                                                                              |
|      | законном основании необходимых |                                                                                                              |
|      | для              осуществления |                                                                                                              |
|      | фармацевтической  деятельности |                                                                                                              |
|      | оборудования   и    помещений, |                                                                                                              |
|      | соответствующих  установленным |                                                                                                              |
|      | требованиям, права на  которые |                                                                                                              |
|      | не  зарегистрированы в  Едином |                                                                                                              |
|      | государственном  реестре  прав |                                                                                                              |
|      | на   недвижимое  имущество   и |                                                                                                              |
|      | сделок с  ним  (в случае  если |                                                                                                              |
|      | такие права зарегистрированы в |                                                                                                              |
|      | указанном  реестре -  сведения |                                                                                                              |
|      | об   этих   помещениях)    (за |                                                                                                              |
|      | исключением        медицинских |                                                                                                              |
|      | организаций,      обособленных |                                                                                                              |
|      | подразделений      медицинских |                                                                                                              |
|      | организаций)                   |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
| 13.  | Сведения о             наличии | Реквизиты санитарно-эпидемиологического заключения:                                                          |
|      | санитарно-эпидемиологи-ческого |                                                                                                              |
|      | о    соответствии    помещений |                                                                                                              |
|      | требованиям санитарных  правил |                                                                                                              |
|      | (за  исключением   медицинских |                                                                                                              |
|      | организаций,      обособленных |                                                                                                              |
|      | подразделений      медицинских |                                                                                                              |
|      | организаций),   выданного    в |                                                                                                              |
|      | установленном                  |                                                                                                              |
|      |                                |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
| 14.  | Сведения о наличии лицензии на |                                                                                                              |
|      | осуществление медицинской      |                                                                                                              |
|      | деятельности (для  медицинских |                                                                                                              |
|      | организаций)                   |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
| 15.  | Контактный телефон,       факс |                                                                                                              |
|      | соискателя лицензии            |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
| 16.  | Адрес электронной  почты  (при |                                                                                                              |
|      | наличии)                       |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+
| 17.  | Реквизиты документа,           |                                                                                                              |
|      | подтверждающего  факт   уплаты |                                                                                                              |
|      | государственной пошлины,  либо |                                                                                                              |
|      | иные сведения,  подтверждающие |                                                                                                              |
|      | факт     уплаты      указанной |                                                                                                              |
|      | государственной пошлины        |                                                                                                              |
|      |                                |                                                                                                              |
+------+--------------------------------+--------------------------------------------------------------------------------------------------------------+

* нужное указать.
в лице
_______________________________________________________________________

______________________________________________________________________,
     (Ф.И.О., должность руководителя юридического лица или 
                   индивидуального предпринимателя)                   
действующего на основании _______________________________________,
                            (документ, подтверждающий полномочия)     
просит  предоставить  лицензию   на   осуществление   фармацевтической
деятельности.
Достоверность представленных документов подтверждаю.
Руководитель
организации-соискателя лицензии
__________________________________
         (ФИО, подпись)

М.П.       "____" _____________ 20___ г.



      ПРИЛОЖЕНИЕ
      к заявлению (для юридического лица или индивидуального
      предпринимателя) о предоставлении лицензии
      на осуществление фармацевтической деятельности
                                                                      
                                                                      
                              ОПИСЬ ДОКУМЕНТОВ                        

Настоящим  удостоверяется, что лицензиат_____________________________,
                                            (наименование лицензиата)
______________________________________________________________________

представил, а лицензирующий орган - Министерство здравоохранения
Республики Коми,______________________________________________________
                          (наименование лицензирующего органа)  
принял  "___"  ___________  20___  г.  за  N  __________в   количестве
_________  листов  нижеследующие документы для предоставления лицензии
на осуществление фармацевтической деятельности:

+------+----------------------------------------+---------------+---------------+
|  N   |         Наименование документа         |  Количество   | Дополнительно |
| п/п  |                                        |    листов     | представлено  |
+------+----------------------------------------+---------------+---------------+
|  1.  | Заявление                              |               |               |
+------+----------------------------------------+---------------+---------------+
|  2.  | Копии учредительных документов         |               |               |
|      | юридического лица,                     |               |               |
|      | засвидетельствованные в нотариальном   |               |               |
|      | порядке                                |               |               |
+------+----------------------------------------+---------------+---------------+
|  3.  | Копии документов,       подтверждающих |               |               |
|      | наличие у соискателя лицензии на праве |               |               |
|      | собственности  или  на  ином  законном |               |               |
|      | основании       необходимых        для |               |               |
|      | осуществления         фармацевтической |               |               |
|      | деятельности оборудования и помещений, |               |               |
|      | соответствующих          установленным |               |               |
|      | требованиям,  права   на  которые   не |               |               |
|      | зарегистрированы       в        Едином |               |               |
|      | государственном   реестре   прав    на |               |               |
|      | недвижимое имущество и сделок с ним (в |               |               |
|      | случае      если      такие      права |               |               |
|      | зарегистрированы в указанном реестре - |               |               |
|      | сведения  об   этих  помещениях)   (за |               |               |
|      | исключением  медицинских  организаций, |               |               |
|      | обособленных подразделений медицинских |               |               |
|      | организаций)                           |               |               |
+------+----------------------------------------+---------------+---------------+
|  4.  | Сведения о                     наличии |               |               |
|      | санитарно-эпидемиологического          |               |               |
|      | заключения  о  соответствии  помещений |               |               |
|      | требованиям   санитарных  правил   (за |               |               |
|      | исключением  медицинских  организаций, |               |               |
|      | обособленных подразделений медицинских |               |               |
|      | организаций),       выданного        в |               |               |
|      | установленном порядке                  |               |               |
+------+----------------------------------------+---------------+---------------+
|  5.  | Копии документов о высшем или  среднем |               |               |
|      | фармацевтическом     образовании     и |               |               |
|      | сертификатов   специалистов   -    для |               |               |
|      | осуществления         фармацевтической |               |               |
|      | деятельности    в   сфере    обращения |               |               |
|      | лекарственных средств для медицинского |               |               |
|      | применения       (за       исключением |               |               |
|      | обособленных подразделений медицинских |               |               |
|      | организаций)                           |               |               |
+------+----------------------------------------+---------------+---------------+
|  6.  | Копии документов   о    дополнительном |               |               |
|      | профессиональном  образовании в  части |               |               |
|      | розничной   торговли    лекарственными |               |               |
|      | препаратами      для      медицинского |               |               |
|      | применения  и   о  наличии  права   на |               |               |
|      | осуществление медицинской деятельности |               |               |
|      | -  для осуществления  фармацевтической |               |               |
|      | деятельности    в   сфере    обращения |               |               |
|      | лекарственных средств для медицинского |               |               |
|      | применения       в        обособленных |               |               |
|      | подразделениях медицинских организаций |               |               |
+------+----------------------------------------+---------------+---------------+
|  7.  | Копии документов   или  заверенные   в |               |               |
|      | установленном   порядке   выписки   из |               |               |
|      | документов,    которые    подтверждают |               |               |
|      | наличие необходимого  стажа работы  по |               |               |
|      | специальности      у      руководителя |               |               |
|      | организации,           индивидуального |               |               |
|      | предпринимателя                        |               |               |
+------+----------------------------------------+---------------+---------------+
|  8.  | Доверенность                           |               |               |
+------+----------------------------------------+---------------+---------------+

Документы сдал:                           Документы принял:

соискатель лицензии / представитель       должностное лицо лицензирующего органа:
соискателя лицензии:
___________________________________       _______________________________________
___________________________________       _______________________________________
      (Ф.И.О., должность, подпись)             (Ф.И.О., должность, подпись)
___________________________________
___________________________________
        (реквизиты доверенности)



      ПРИЛОЖЕНИЕ N 2
      к Административному регламенту предоставления
      государственной услуги по лицензированию фармацевтической
      деятельности (за исключением деятельности, осуществляемой
      организациями оптовой торговли лекарственными средствами
      и аптечными организациями, подведомственными
      федеральным органам исполнительной власти,
      государственным академиям наук)


Регистрационный номер: __________________________________    от_______
                      (заполняется лицензирующим органом)

                                        В Министерство здравоохранения
                                                       Республики Коми

                                 Заявление                            
                 о переоформлении лицензии на осуществление           
                       фармацевтической деятельности                  

Регистрационный  N___________ лицензии   от   ______    ______________
20___года,

предоставленной ______________________________________________________
                       (наименование лицензирующего органа)

      I. В связи с:
      * реорганизацией юридического лица в форме преобразования
      * реорганизацией юридического лица в форме слияния
      * изменением наименования юридического лица
      * изменением адреса места нахождения юридического лица
      * изменением места жительства индивидуального предпринимателя
      *  изменением  имени,  фамилии   и   (если   имеется)   отчества
индивидуального предпринимателя
      *  изменением  реквизитов  документа,  удостоверяющего  личность
индивидуального предпринимателя
      *   изменением   адреса    места    осуществления    юридическим
лицом/индивидуальным предпринимателем лицензируемого вида деятельности
при фактически неизменном месте

+-----+----------------------------+----------------------------------+--------------------------------+
| N   |    Сведения о заявителе    |             Сведения             |         Новые сведения         |
| п/п |                            |     о лицензиате/лицензиатах     |      о лицензиате или его      |
|     |                            |                                  |         правопреемнике         |
+-----+----------------------------+----------------------------------+--------------------------------+
| 1.  | Организационно-правовая    |                                  |                                |
|     | форма и полное             |                                  |                                |
|     | наименование юридического  |                                  |                                |
|     | лица/фамилия, имя,         |                                  |                                |
|     | отчество (в случае, если   |                                  |                                |
|     | имеется), данные           |                                  |                                |
|     | документа, удостоверяющего |                                  |                                |
|     | личность, индивидуального  |                                  |                                |
|     | предпринимателя            |                                  |                                |
+-----+----------------------------+----------------------------------+--------------------------------+
| 2.  | Сокращенное наименование   |                                  |                                |
|     | (в случае, если имеется)   |                                  |                                |
+-----+----------------------------+----------------------------------+--------------------------------+
| 3.  | Фирменное наименование (в  |                                  |                                |
|     | случае, если имеется)      |                                  |                                |
+-----+----------------------------+----------------------------------+--------------------------------+
| 4.  | Адрес места нахождения     |                                  |                                |
|     | юридического лица/место    |                                  |                                |
|     | жительства индивидуального |                                  |                                |
|     | предпринимателя (с         |                                  |                                |
|     | указанием почтового        |                                  |                                |
|     | индекса)                   |                                  |                                |
+-----+----------------------------+----------------------------------+--------------------------------+
| 5.  | Государственный            |                                  |                                |
|     | регистрационный номер      |                                  |                                |
|     | записи о создании          |                                  |                                |
|     | юридического лица/         |                                  |                                |
|     | государственный            |                                  |                                |
|     | регистрационный номер      |                                  |                                |
|     | записи о государственной   |                                  |                                |
|     | регистрации                |                                  |                                |
|     | индивидуального            |                                  |                                |
|     | предпринимателя            |                                  |                                |
+-----+----------------------------+----------------------------------+--------------------------------+
| 6.  | Данные документа,          |      Выдан ____________________  |      Выдан ___________________ |
|     | подтверждающего факт       | (орган, выдавший документ)       | (орган, выдавший документ)     |
|     | внесения сведений о        |                                  |                                |
|     | юридическом лице в Единый  |      Дата выдачи:                |      Дата выдачи:              |
|     | государственный реестр     | _____________________            | ____________________           |
|     | юридических лиц/ сведений  |                                  |                                |
|     | об индивидуальном          | Бланк:                           |  Бланк:                        |
|     | предпринимателе в Единый   | серия_________________           |  серия _______________         |
|     | государственный реестр     |      N ___________________       |       N ___________________    |
|     | индивидуальных             |      Адрес________________       |       Адрес________________    |
|     | предпринимателей, с        |      _____________________       |       _____________________    |
|     | указанием адреса места     |                                  |                                |
|     | нахождения органа,         |                                  |                                |
|     | осуществившего             |                                  |                                |
|     | государственную            |                                  |                                |
|     | регистрацию                |                                  |                                |
+-----+----------------------------+----------------------------------+--------------------------------+
| 7.  | Данные документа,          | Выдан ____________________________________________                |
|     | подтверждающего факт       |                                   (орган, выдавший документ)      |
|     | внесения соответствующих   |                                                                   |
|     | изменений в Единый         | Дата выдачи _________________                                     |
|     | государственный реестр     |                                                                   |
|     | юридических лиц/ Единый    | Бланк: серия ______________ N ______________                      |
|     | государственный реестр     |                                                                   |
|     | индивидуальных             |      Адрес_____________________________________                   |
|     | предпринимателей           |      _________________________________________                    |
|     |                            |                                                                   |
+-----+----------------------------+-----------------------------------+-------------------------------+
| 8.  | Идентификационный номер    |                                   |                               |
|     | налогоплательщика          |                                   |                               |
+-----+----------------------------+-----------------------------------+-------------------------------+
| 9.  | Данные документа о         |      Выдан ____________________   |      Выдан                    |
|     | постановке лицензиата      | (орган, выдавший документ)        | ___________________ (орган,   |
|     | (юридического лица,        |                                   | выдавший документ)            |
|     | индивидуального            |      Дата выдачи: _______________ |                               |
|     | предпринимателя) на учет   |                                   |      Дата выдачи:             |
|     | в налоговом органе         | Бланк:                            | ______________                |
|     |                            | серия_________________            |                               |
|     |                            |      N ___________________        | Бланк:                        |
|     |                            |      Адрес_________________       | серия _____________           |
|     |                            |      ______________________       |       N_________________      |
|     |                            |                                   |       Адрес_____________      |
|     |                            |                                   |       ___________________     |
|     |                            |                                   |                               |
+-----+----------------------------+-----------------------------------+-------------------------------+
| 10. | Сведения о                 |                                                                   |
|     | распорядительном           |      ______________________________________________________       |
|     | документе, на основании    |                                         (орган, принявший         |
|     | которого произошло         | решение)                                                          |
|     | изменение адреса места     |                                                                   |
|     | осуществления деятельности |      Реквизиты документа _____________________________            |
|     |                            |                                                                   |
+-----+----------------------------+-----------------------------------+-------------------------------+
| 11. | Адрес(а) мест              |                                   | 1. Аптечные организации:      |
|     | осуществления              |                                   | *Аптека готовых лекарственных |
|     | лицензируемого вида        |                                   | форм                          |
|     | деятельности.              |                                   | _______________________       |
|     |                            |                                   |  (адрес места осуществления   |
|     | Выполняемые работы,        |                                   |      лицензируемого вида      |
|     | оказываемые услуги,        |                                   |         деятельности)         |
|     | составляющие               |                                   |                               |
|     | фармацевтическую           |                                   | 1) розничная торговля         |
|     | деятельность в сфере       |                                   | лекарственными препаратами    |
|     | обращения лекарственных    |                                   | для медицинского применения;  |
|     | средств для медицинского   |                                   | 2) хранение лекарственных     |
|     | применения                 |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 3) отпуск лекарственных       |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 4) перевозка лекарственных    |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения.                   |
|     |                            |                                   |                               |
|     |                            |                                   | *Аптека производственная      |
|     |                            |                                   | _______________________       |
|     |                            |                                   |  (адрес места осуществления   |
|     |                            |                                   |      лицензируемого вида      |
|     |                            |                                   |         деятельности)         |
|     |                            |                                   | 1) розничная торговля         |
|     |                            |                                   | лекарственными препаратами    |
|     |                            |                                   | для медицинского применения;  |
|     |                            |                                   | 2) хранение лекарственных     |
|     |                            |                                   | средств для медицинского      |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 3) отпуск лекарственных       |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 4) перевозка лекарственных    |
|     |                            |                                   | средств для медицинского      |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 5) изготовление лекарственных |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения.                   |
|     |                            |                                   |                               |
|     |                            |                                   | *Аптека производственная    с |
|     |                            |                                   | правом           изготовления |
|     |                            |                                   | асептических    лекарственных |
|     |                            |                                   | препаратов                    |
|     |                            |                                   | _______________________       |
|     |                            |                                   |  (адрес места осуществления   |
|     |                            |                                   |      лицензируемого вида      |
|     |                            |                                   |         деятельности)         |
|     |                            |                                   |                               |
|     |                            |                                   | 1) розничная торговля         |
|     |                            |                                   | лекарственными препаратами    |
|     |                            |                                   | для медицинского применения;  |
|     |                            |                                   | 2) хранение лекарственных     |
|     |                            |                                   | средств для медицинского      |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 3) отпуск лекарственных       |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 4) перевозка лекарственных    |
|     |                            |                                   | средств для медицинского      |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 5) изготовление лекарственных |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения.                   |
|     |                            |                                   |                               |
|     |                            |                                   | *Аптечный пункт               |
|     |                            |                                   | _______________________       |
|     |                            |                                   |  (адрес места осуществления   |
|     |                            |                                   |      лицензируемого вида      |
|     |                            |                                   |         деятельности)         |
|     |                            |                                   |                               |
|     |                            |                                   | 1) розничная торговля         |
|     |                            |                                   | лекарственными препаратами    |
|     |                            |                                   | для медицинского применения;  |
|     |                            |                                   | 2) хранение лекарственных     |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 3) отпуск лекарственных       |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 4) перевозка лекарственных    |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения.                   |
|     |                            |                                   |                               |
|     |                            |                                   | *Аптечный киоск               |
|     |                            |                                   | _______________________       |
|     |                            |                                   |  (адрес места осуществления   |
|     |                            |                                   |      лицензируемого вида      |
|     |                            |                                   |         деятельности)         |
|     |                            |                                   |                               |
|     |                            |                                   | 1) розничная торговля         |
|     |                            |                                   | лекарственными препаратами    |
|     |                            |                                   | для медицинского применения;  |
|     |                            |                                   | 2) хранение лекарственных     |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 3) перевозка лекарственных    |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения.                   |
|     |                            |                                   |                               |
|     |                            |                                   | 2. Структурные подразделения  |
|     |                            |                                   | медицинских организаций:      |
|     |                            |                                   |                               |
|     |                            |                                   | *Аптека готовых лекарственных |
|     |                            |                                   | форм                          |
|     |                            |                                   | _______________________       |
|     |                            |                                   |  (адрес места осуществления   |
|     |                            |                                   |      лицензируемого вида      |
|     |                            |                                   |         деятельности)         |
|     |                            |                                   | 1) розничная торговля         |
|     |                            |                                   | лекарственными препаратами    |
|     |                            |                                   | для медицинского применения;  |
|     |                            |                                   | 2) хранение лекарственных     |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 3) отпуск лекарственных       |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 4) перевозка лекарственных    |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения.                   |
|     |                            |                                   |                               |
|     |                            |                                   |                               |
|     |                            |                                   |                               |
|     |                            |                                   |                               |
|     |                            |                                   |                               |
|     |                            |                                   |                               |
|     |                            |                                   | *Аптека производственная      |
|     |                            |                                   | _______________________(адрес |
|     |                            |                                   |      места осуществления      |
|     |                            |                                   |      лицензируемого вида      |
|     |                            |                                   |         деятельности)         |
|     |                            |                                   |                               |
|     |                            |                                   | 1) розничная торговля         |
|     |                            |                                   | лекарственными препаратами    |
|     |                            |                                   | для медицинского применения;  |
|     |                            |                                   | 2) хранение лекарственных     |
|     |                            |                                   | средств для медицинского      |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 3) отпуск лекарственных       |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 4) перевозка лекарственных    |
|     |                            |                                   | средств для медицинского      |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 5) изготовление лекарственных |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения.                   |
|     |                            |                                   |                               |
|     |                            |                                   | *Аптека производственная с    |
|     |                            |                                   | правом изготовления           |
|     |                            |                                   | асептических лекарственных    |
|     |                            |                                   | препаратов                    |
|     |                            |                                   | _______________________       |
|     |                            |                                   |  (адрес места осуществления   |
|     |                            |                                   |      лицензируемого вида      |
|     |                            |                                   |         деятельности)         |
|     |                            |                                   | 1) розничная торговля         |
|     |                            |                                   | лекарственными препаратами    |
|     |                            |                                   | для медицинского применения;  |
|     |                            |                                   | 2) хранение лекарственных     |
|     |                            |                                   | средств для медицинского      |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 3) отпуск лекарственных       |
|     |                            |                                   | препаратов для медицинского   |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 4) перевозка лекарственных    |
|     |                            |                                   | средств для медицинского      |
|     |                            |                                   | применения;                   |
|     |                            |                                   | 5) изготовление лекарственных |