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["附件2"]
["药品/医用耗材配送企业报名信息登记表"]
["序号","企业名称","经营场所","联系人","联系人电话","经营许可证编号","经营许可证经营范围","备案凭证号","备案凭证经营范围","统一社会信用代码","账号名称"]
[1,"例：xxxxxx药品\n有限公司","xxxxxx","XXX","XXXXXXXXXXX","例：蒙AAxxxxxxx","例：中成药、中药材、抗生素、化学原料药***","不用填写","不用填写"]
["2","例：xxxxxx医疗器械\n有限公司","xxxxxx","XXX","XXXXXXXXXXX","例：内乌食药监械经营许20190074号","例：2002年目录：6804,6815 6821,6822,6823,6824, 6825,6826,6828,6830,6832，6833，6840(诊断试剂不需低温冷藏运输贮）***\n2017年目录:01，02,03,04,05,06，07，6840 (不需冷链运输）","事例：内乌食药监械经营备20190139号","例：2002年目录分类：6820,6821,6823,6826,6827,6840,6854,6857,6864,6866.  2017年目录分类：07,08,09,11,14,18,19,20,22"]
["注：1.经营场所按照药品/医疗器械经营许可证填写，如生产企业直接配送，按照药品/医疗器械生产许可证填写。"]
["        2.医用耗材企业经营许可证经营范围只需填写数字编号，不需填写数字后面的汉字，如数字后面有括号，括号内容需填写，参照例子填写。"]
["        3.可以在内蒙古自治区药采平台中正常配送的企业填写账号名称（企业账号），不能正常配送的，填写“无”。"]